One of the major advantages of becoming a PA is that it is relatively easy to change from one specialty to another without the need for new certification. Robert Concini, PA-C, in vascular surgery at Lourdes Hospital in Binghamton, New York, spent decades of his PA career in cardiac surgery. Eighty-hour work weeks were common, situations were life and death, and the work was tremendously rewarding. But when burnout was hovering around the corner, Concini made the choice to switch to general surgery, and, after a decade in that specialty, switched again to vascular surgery.
“I feel grateful to have always had engaging and rewarding work as a PA, but burnout is real, and the option to switch specialties allowed me to avoid burnout and continue to function at my best,” explains Concini. “When I switched from cardiac surgery to general surgery, the surgeries weren’t as long or as life-threatening, and it saved me from burnout.”
How a PA’s well-rounded education makes changing specialties possible
Six to seven percent of PAs are changing specialties each year, according to AAPA’s annual Salary Report. Because PAs receive general medical and surgical education and are required to recertify regularly, they can often change specialties without needing any new certification. Some employers may prefer an additional specialty-specific certification, but it’s not required for licensure or to practice in a different specialty. Concini feels that this broader education has made changing specialties easier.
“It used to be that we needed to pass our recertification exam [PANRE] every two years, now it’s every 10 years. To pass our boards, we have to be able to answer questions about all specialties, including cardiac surgery, pediatrics, general surgery, and emergency care,” says Concini. “It’s built into our career that we are constantly training and learning about new breakthrough ways of doing things. In vascular surgery, for example, we’re performing procedures now that didn’t use to exist.”
Switching specialties can help PAs find needed work-life balance
Ted Smith, PA-C, went back and forth from orthopedics to emergency medicine, depending upon the needs of his personal life. There were times when he needed the Monday through Friday, 9 to 5 lifestyle that orthopedics supplied.
“When I first got out of school, I did some family practice for a couple of years and then I did ortho,” Smith says. “After that I went to the ER for quite a while. In one ER job, we worked 24-hour shifts, eight shifts a month, and I had a two-hour drive. I had to be there at 7:00 a.m., which meant getting up at 4:00 a.m., driving for two hours, working 24 hours, and then driving two hours back home. There were days when I got home, took a nap on the couch and woke up wondering, ‘How did I get home?’ Not good. When I went back to ortho, it was because I had personal reasons for needing that Monday through Friday, 9 to 5 job. Once those personal issues were resolved, I went back to emergency care but decided to go locums so I could keep myself from burning out.”
How difficult is it to change specialties?
While the broad education makes it easier, some specialties require PAs to acquire additional training and experience. Smith explains, “If I hadn’t had a background in orthopedics, it would have been much more difficult to switch back to ortho when I needed to. My shift to the ER was also supported by my background experience. As a paramedic, I was always in and out of emergency rooms, helping nurses, starting IV’s, helping physicians, etc.” In addition, if a PA chooses to move into a new specialty where additional training would be beneficial or preferred, the demand for PAs is high enough that the needed education can often be built into a job offer.
How changing specialties can improve a PA's financial situation
According to the AAPA 2019 Salary Report, a PA's salary can more than double depending on the location and the specialty. The demanding technical work, the number of patients seen in a week, and the number of hours worked in a week all factor into the different pay scales for each specialty.
Why a PA may choose NOT to change specialties
“When you get a good team and you work well together, you stay,” states Justin Corbit, CVT, PA-C, with SSM Health Dean Medical Group in Madison, Wisconsin “There’s such a high need for PAs right now that teams need to function well together or PAs will be lost to a higher offer somewhere else. Turnover in our group has been very slow because we have such a good group. People are incentivized to stay in a good job. I feel genuinely bad if someone doesn’t have a job that they’re happy with. I’m incredibly blessed. Things have worked out well for me and I’m very thankful. I’m not going anywhere.”