Things I wish I knew before my first year as a new grad PA

Just passed my 1-year mark and wanted to share some things I learned the hard way. Our program prepared us clinically but nobody really talks about the day-to-day workflow stuff.

On clinical knowledge: You will not know everything. You will feel like a fraud sometimes. This is normal and it gets better. I kept a running list of every question I couldn't answer and looked them up that night. Within 3 months the list started getting shorter.

On documentation: This was my biggest struggle. I was spending 2+ hours after clinic finishing my notes because I was trying to remember details from 20 patient encounters. What saved me was doing a quick voice note between patients in Willow Voice. Just 30-45 seconds of key findings, plan, and anything unusual. I pull up the transcript when I write my notes and it cuts the time in half. My supervising physician noticed my notes got more detailed too, which helped at my review.

On relationships with staff: Be nice to the MAs and nurses. Seriously. They know things you don't and they can make or break your day. Bring coffee sometimes. Ask about their weekends. It matters.

On asking for help: Ask your supervising physician questions early and often. Most prefer a new grad who asks too many questions over one who stays quiet and makes mistakes. I asked probably 10-15 questions a day for the first 3 months and nobody once made me feel bad about it.

On work-life balance: Set boundaries early or you never will. I stopped answering MyChart messages after 7pm. The world didn't end. Patients can wait until morning for non-urgent stuff.

On imposter syndrome: Talk to other new grads. I promise they feel the same way. I joined a PA Facebook group for new grads and it was weirdly comforting to see everyone else struggling with the same things.

What would you add? Especially from those of you a few years out.