By Eric Kingsley- Essay Guest Author
One of my favorite questions that I get asked on social media is:
How do I get hired as a new graduate PA in cardiothoracic surgery?
A lot of people will ask me, “I didn’t think programs hired new graduates in CT surgery. How did you get a job?”
I’m happy to answer those questions for as many people as I can, but sometimes, I don’t have the time to be as thorough as I would like to be, so here I am. This is my best advice, based on my experience, to get a job as a new graduate in Cardiothoracic Surgery.
In my opinion, there are three basic pathways to get a job and learn the skills required to be a proficient cardiac surgery PA who can do it all: work in the OR and harvest conduit (saphenous veins or radial arteries) endovascularly, work in the ICU, and perform at a high level in the outpatient setting. All of these skills are important for a CT surgery PA, but operating and learning how to harvest vein or artery conduit is the most sought-after skill from an employment perspective. It is also the most difficult skill that you will learn, in my opinion.
Going back to what I alluded to earlier about the three basic pathways to obtain the necessary skills to become a competent CT surgery PA:
- Get hired directly out of school to a job that is willing to train you.
- Get accepted to a one-year fellowship in CT surgery (e.g., Emory University).
- Work another job in surgery and transition into cardiac surgery.
Getting a fellowship is a great option, but there are only approximately 20 positions offered across the USA in 2025. However, if you can land one of these fellowships, getting a job post-graduation should be straightforward. I am going to focus mostly on number one—getting a CT surgery job right out of PA school.
Hopefully, you are reading this prior to graduation or while you are choosing your electives because having a CT surgery rotation is going to be very important. It is important not because you are going to be ready to operate after a 6-8 week rotation, but rather because you need to have some perspective when you go to apply for a position. Perspective is tremendously important for you as a new graduate because you need to make the hiring team, PAs, and surgeons feel confident in your dedication to the CT surgery profession and lifestyle. CT surgery is not primary care. CT surgery is not aesthetic dermatology. This is not a lifestyle profession. This is a profession for those who love cardiac surgery and helping others. Cardiac surgery requires that you work long hours, work through lunch and maybe dinner. You will take call to the OR and maybe the ICU and the floor. There will be bad days. There will be sick patients that you want to save, but you can’t. You will need to learn a tremendous amount of new information after graduation. You will likely feel overwhelmed and underprepared. But you need to love it. And I think you need to have a reason to continue to wake up and do this difficult job day in and day out.
All that to say, you need perspective when you apply. Now, if you are still with me, when you apply, you need to show them all the experience that you have. That means logging every single case you witness and scrub. It means writing a cover letter that shows your passion and conviction. It means telling a story about a case that you witnessed or how you felt when you first scrubbed into an open-heart case. They need to feel that you are all in and you are not going to give up when things become difficult. It’s all about making them feel confident in you.
When should you apply?
After you have written a wonderful cover letter and resume, you need to begin applying. If you are graduating in September and plan to take the PANCE immediately after graduation, you should begin applying to jobs in May. This gives you enough time to interview and onboard so that you can be employed and start your job after your PANCE.
Where should you apply?
Everywhere and anywhere. Getting a job as a new graduate in CT surgery is hard, of course, and it’s especially hard if you are in a metropolis. So, this means you need to apply and be willing to go where senior CT PAs won’t. This means being willing to move. However, the move doesn’t need to be permanent. You need the experience, and they need the help.
How to improve your chances of being hired?
First and foremost, you need to be a strong applicant with a well-written resume and cover letter that demonstrates competency and passion. Then you need to apply if you see a posting. I recommend going straight to the hospital’s site and applying. Avoid Indeed, Monster, etc., and go straight to the hospital’s site. Then, you need to start reaching out to anyone you can who can give you an edge over your competition. Reach out to HR managers, hiring directors, the surgeons, the PAs, whoever you can to amplify your application. My recommendation is to find these people on LinkedIn.
Now you’ve gotten an interview invite!
Typically, your first interview is going to be on the phone, and you will speak with the recruiter in charge of finding the qualified candidates. Then you might speak with the administrative staff (e.g., office manager). After that, you will likely meet with the surgical staff. Once you have made it to this step, you know you’re close.
After you have met with the surgical staff, it is important to now consider: Is this the job that I have been yearning for? Am I going to be trained? Will I have a mentor? Is this an ICU or clinic-only job? Are the volumes high enough for me to comfortably learn EVH? Do I get along with the surgical staff? Why are they having staffing shortages?
If you feel confident in the job and are offered employment, you don’t have much to counter-negotiation with when it comes to salary, but tools you should use are the APACVTS salary guide and the AAPA salary guide. Considerations include call pay, overtime, and weekend pay. You do not want to be in the hospital 15 days in a row, month after month, without incentive. When you make it to this step, make sure to reach out for contract negotiation assistance.
After you have been hired, credentialed, and onboarded, you need to work like crazy. The start of your career needs to be treated like school. You need to go in early, work efficiently, get in the OR and scrub every single case you can, and do not miss an opportunity to help prep the vein, suture the skin, put a dressing on a patient, or any other introductory skill. Everything is going to be new to you. You need repetitions. You need exposure. You need to get every minute of experience you can.
If you are not getting the experience you need and want, you’ll need to decide whether you are going to stay in that job or move again. After six months, you are not as green as you were when you first started. You are likely just starting to get your legs under you at this point. At six months, however, you are much more hirable than you were when you were a baby-faced new graduate. So, if you need to move on to develop your skill, then so be it. I did it, and it was totally worth it. I ended up at a higher-volume program and expedited my training tremendously.
Literature you should read before you start:
Perioperative care in Cardiac Surgery
If you’ve somehow managed to read this whole article, you must be dedicated to cardiac surgery. Some jobs are more than just jobs—they are a purpose, they make a difference, and they are worth it.