Becoming a PA: 3 Things I Wish I Knew From The Start

PA Coaching • May 27, 2023

In this video, I’ll be talking about three things that I wish I knew before becoming a PA. If you’re thinking about becoming a PA or are currently in the process of becoming one, this video is for you!

3 Things I Wish I Knew Before Becoming a PA

Becoming a Physician Assistant (PA) is an exciting and fulfilling career choice for many. However, there are a few important things that I wish I had known before stepping into the role. Whether you’re a new graduate or a student about to enter the field, it’s crucial to be aware of these aspects that can impact your journey as a PA. In this article, I will share three key things that I wish I had known before becoming a PA.

The Lengthy Process of Starting Work as a PA

One of the first things that took me by surprise was the amount of time it actually takes to start working as a practicing PA after graduation. There are several steps involved, including passing your boards, obtaining a state license, and going through the credentialing process. These processes can take a couple of months, and it’s important to factor in this time lag when planning your transition from PA school to practice.

I highly recommend watching my previous video on PA certification and licensure, as it delves into the details of this process. Understanding the steps and timelines involved will help you better prepare for the waiting period between graduation and starting your first job as a practicing PA. It’s essential to be aware of this aspect and plan accordingly to avoid any financial or logistical challenges during this transitional phase.

The Influence of Insurance Companies on Patient Decisions

In the United States, I was not fully aware of the significant influence that insurance companies have on patient decisions. As medical providers, our primary goal is to make the best medical decisions for our patients’ well-being and outcomes. However, insurance companies often play a role in determining what treatments, medications, or tests will be covered for patients.

It can be frustrating to recommend a specific course of action, only to face resistance from insurance companies. They may deny coverage for certain tests, treatments, or procedures and suggest alternative options. As a PA, you will sometimes find yourself advocating for the best interests of your patients, engaging in discussions with insurance companies to ensure that they receive the most appropriate care.

Navigating the influence of insurance companies can be challenging, but it’s crucial to stand up for what you believe is the right treatment or test for your patients. If alternative options are required due to insurance limitations, work towards achieving the same desired outcome while considering the available resources. Understanding this aspect before entering practice will help you navigate the complex landscape of healthcare and insurance systems more effectively.

Certification and Licensure Maintenance Requirements

While it may seem obvious, I underestimated the importance of staying on top of certification and licensure maintenance requirements. After graduation, obtaining your certification and license marks a significant achievement. However, it’s essential to be aware that maintaining these credentials requires ongoing efforts.

Certification maintenance for PAs typically involves completing a certain number of continuing medical education (CME) hours within a specific time period. For example, PAs are usually required to accumulate a hundred hours of CME during a set timeframe to maintain their certification. It’s crucial to understand these requirements, log your CME hours diligently, and keep proper documentation to support your compliance.

Additionally, you must also stay informed about licensure renewal requirements, which may vary based on your state and employer. Renewing licenses typically involves submitting documentation, paying fees, and meeting specific criteria every one to two years.

To avoid finding yourself scrambling to meet these requirements, make it a priority to stay organized and proactive. Familiarize yourself with the certification maintenance requirements outlined by the National Commission on Certification of Physician Assistants (NCCPA) and be mindful of renewal timelines for your license. By staying on top of these obligations, you ensure the continuity of your practice and avoid unnecessary stress down the road.


Becoming a PA is an exciting and rewarding career choice, but it comes with its own set of challenges and considerations. By being aware of these three key aspects, you can better prepare yourself for a successful transition into practice. Understanding the timeline for starting work as a PA, recognizing the influence of insurance companies, and staying on top of certification and licensure maintenance requirements will contribute to a smoother professional journey. Stay informed, stay proactive, and learn from the experiences of others to make the most of your career as a PA.

Also read: How to Study for the PANCE Exam

About me:

I’m Michele Neskey, aka The Posh PA. Welcome to my YouTube channel! My mission is to provide personalized guidance, education, and motivation to build confidence and promote wellness for aspiring physician assistants and beyond.   

Having been a PA for 17+ years and helped hundreds of students gain acceptance into PA school,  I understand the admissions process. I know what they are looking for, and I can help you tailor every component to make you shine, giving you the BEST chance of getting accepted to a program.  But it doesn’t end there. I create personalized plans for PA students and practicing PAs including test-taking strategy for the PANCE, contract negotiations, and tools to overcome and prevent provider burnout. 

My goal is to get you into a physician assistant (PA) school & survive the rigorous program, help you prevent burnout as a practicing PA, and help you take care of yourself so you can be the best version of YOU for your patients, family, and most importantly YOU!