Somehow, since I started this blog in the Summer of 2021, a few people have reached out to me on the AMA page and sent me emails asking some good questions. Although I have replied to them independently, their questions were fantastic and I thought I would start a little series over the next few weeks with some the questions I received, with my responses. Please keep them coming so I can do this regularly.

I am just about to graduate as an FNP, and joining the foreign service is a career goal of mine. What type of experience would you recommend that would make me a competitive applicant?

This is a fantastic question.

Short Answer:

A true outpatient family practice clinic, urgent care, or emergency room.

Long Answer:

The posting for the job wants someone whose background is predominately primary care, treating all ages groups. It seems straight forward enough until you start getting into some of the application questions, where they also want to know your experience in higher acuity situations or in trauma situations. Last time I checked, primary care didn’t really deal with serious inpatient issues, and folks with limbs flying off aren’t knocking on their primary care providers door too often.

Specifically, I would try and find a job where your main roll will be outpatient primary care, ideally with all age groups, but also allows you an opportunity to do some inpatient rounding at either hospitals or acute rehab facilities. This is easier said than done, especially if you live in a larger city where full service family practice settings are rare, and primary/inpatient care is much more fractured along specialties like pediatricians, hospitalists, and OBGYNs. If jobs like this are hard to come by, I would also consider something like urgent care or even like a fast track ER job. While not really primary care, you will treat all age groups routinely, see some higher acuity things, identify numerous primary care issues, and learn how to work quickly and on your feet. Many of the folks I know in the FS have urgent care/ER backgrounds, so they clearly have no issues getting hired. (These jobs also pay pretty well for new grads, so score)

If you can’t land that full service take all patients primary care job (because it might not exist in your area), don’t fret. On the application, it has a little statement that says if you aren’t predominately experienced in primary care, as long as you can articulate your understanding of it well enough on your application, you will be considered. This absolutely applies to me. The majority of my NP career has been in the inpatient setting, in a small regional trauma facility. I started my NP career in primary care so I clearly know what it is and am comfortable in it, but it was only about 2.5 years of my now 7+ years of NP experience in an overall 15+ year career in the healthcare. Plus, throughout that time, the vast majority of my patients were adults. Pediatric patients were usually just seasonal wellness exams we offered since we were near a middle school and a high school, and it was a cheap/easy way for kids to get signed off for sports. Knowing my weaknesses, I made sure to articulate my experiences well, using real life examples, and here I am in the upper third of the MP Register.

In the end, I would basically try and avoid really focused specialties. An applicant that only has 5 years of orthopedic surgery experience is likely going to have a harder time than someone that works at your generic take all comers “Doc in the Box”. The surgery job might seem more prestigious and might pay more, but if your end game is working in the Foreign Service, it likely isn’t the best route. Finding something that lets you be a bit of a jack of all trades, master of none is the ideal. When you are alone in Sub-Saharan Africa as the only Western trained provider, you are going to have to be the shoulder to cry on, the infectious disease specialist, the pediatrician, the urgent care, the community health nurse, the healthcare diplomat, and more. Nothing in the US will truly ever prepare you for all the hats you are going to have to wear as an MP in the FS, but going broader in your experience will be much more helpful than specializing when it starts to really matter.

Hope this helped! Next week we will take a look at salary and benefits for medical providers.