PA vs MD (free vs debt)

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ua2011

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So I'm trying to decide my life and finally make a decision this year. I know I want to enter the field of medicine (not nursing, pharmacy, ect). I have been working in a hospital for 3 years, I have my Bachelors degree, and I know I enjoy working with patients. I have all the pre-requisites for both PA and MD schools, but still studying for the MCAT. I'm trying to decide in what capacity I would like to practice medicine either as a PA or MD. I decided if I do pursue PA I will apply for the NHSC scholarship, which provides a living stipend + cost of tuition and fees for two years of service in an undeserved area (the hospital I've been working at treats the undeserved and is a government funded). I believe I will have a very high likelihood of receiving the scholarship. If I choose MD I would not choose the NHSC scholarship because I don't think I could commit 4 years to a certain specialty. I made a pros and cons list of the two below.

About me:
Single, male, 25yo, with no desire to get married or have kids, no undergrad debt.
I feel like my heart is telling me to be an MD, but PA seems the safer and less risky route (brain).

PA

Pros:
1. No debt (NHSC scholarship)
2. Shorter time to complete education
3. More balanced lifestyle (time for family, friends, vacations, ect).
4. Buy home/car MUCH sooner
5. Ability to go into different specialties and not be stuck


Cons:
1. Lack of full autonomy (I like making decisions and being in control)
2. Possible lack of being fully fulfilled (I enjoy learning the details of how things work).
3. Lack of higher earning potential or moving up the ladder (feeling stuck).
4. Lack of expertise

MD

Pros:
1. Being an expert
2. Stronger desire to be an MD (vs PA).
3. Higher future income earning potential.
4. Prestige of being a "Dr."

Cons:
1. DEBT (I would be in debt around 200k to 250k by the time I graduate med school).
2. Lack of time for family and friends (very small family).
3. Step 1 seems like it decides your fate as far as possible specialties

My final thought is I could always go to PA school first and discover what specialty of medicine truly interests me and return to school to pursue my MD while I save money for a few years.

Any input greatly appreciated!
Thank you

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Don't let money (debt) decide a 40+ year career for you. The time factors are very valid so I would highly consider those as factors in your decision. And that's a decision the internet can't really help you make.
 
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There's no doubt you'll get to do more interesting things and have more autonomy as an MD. That being said you can do a lot as a PA. One of my former personal training clients is a PA to a plastic surgeon and first assists on every surgery. You'll likely end up doing a whole lot more of the crap work as a PA, but the money is still plenty and quality of life can be better.

I can only offer limited insight as I'm just getting ready to start med school this fall, but from talking to l physicians I know the prestige part of things wears off pretty quick, so they tell me, so I wouldn't let that sway you towards MD.
 
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So, you don't want kids/ marriage and are willing to live in an underserved area if needed?
Perfect MD candidate!
 
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There are a lot of bright PA's.

They provide much of the "hands on" care in hospitals and many clinics.

They're well-paid (some surgical PA's earn 6 figure salaries in large urban hospitals) and have less hectic schedules.

Nonetheless, you will always be an assistant.

Your training, no matter the program, will be more superficial than a physician who has attended 4 years of medical school and completed an internship and residency.

You won't be the "provider" that is sought for a second opinion.

If you're OK with all of the above, go for the PA.

Your cons #1 and #2 for PA, and pro #1 for MD ,suggest to me, an anonymous random poster, that you'd be more satisfied intellectually accepting the debt, tolerating the longer hours, and becoming a physician.
 
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You realize that, even after the debt, you'll have more money than most PAs as an MD, right? I mean, if the average PA has a working lifetime of 41 years at 100k/year, and the average physician has a working lifetime of 36 years at 200k, you're still making $4.1 million versus $7.2 million. Throwing away $3.1 million dollars because of 300-400k in debt is foolish.
 
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Also remember that there is debt forgiveness for many rural physicians and those practicing in underserved areas. Also many sign-on bonuses help cover some of the cost, so it could be part of your contract when you are hired as a physician.

For example: in the rural area where I am from, a neurologist that visits multiple area hospitals signs a three year contract. After three years the hospital affiliation agrees to pay up to $150K of the neurologist's loans.

https://www.aamc.org/advocacy/meded/79048/student_loan_repayment.htmlhttp://studentloanhero.com/featured/ultimate-student-loan-repayment-guide-for-doctors/
http://studentloanhero.com/featured/ultimate-student-loan-repayment-guide-for-doctors/

Point is that PA and MD probably both have opportunities for loan forgiveness.
 
My final thought is I could always go to PA school first and discover what specialty of medicine truly interests me and return to school to pursue my MD while I save money for a few years.

I don't know if this necessarily makes sense given your original argument that you want to go to school and come out with little debt/a solid plan for debt repayment.
 
They also have the NHSC scholarship for doctors too if that helps your decision at all.

EDIT: just read the part about not wanting to do MD NHSC because you don't want to do a particular specialty. Doesn't the NHSC for PA focus on underrepresented and underprivileged areas too for primary care only?
 
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Okay, first of all, NHSC scholarships are pretty competitive. So I don't think you should make your decison with the assumption that you will receive a highly sought after scholarship if you go PA.

If I choose MD I would not choose the NHSC scholarship because I don't think I could commit 4 years to a certain specialty.
I assume what you're saying is that you wouldn't want to commit to working at an NHSC-funded site for 4 years. (To qualify for NHSC, you have to choose a primary care specialty.) While it's not ideal to have to work where they tell you to, what's 2 more years of service if it means that at the end, you're a doctor making good money?

I think the question you really need to ask yourself is whether you want to be a PA or a MD. Going PA to MD is just a waste of time and money.
 
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Also something you may want to think about, that I just thought of, how will you explain your desire to go to PA school?

The stereotype I am thinking of is a lot of people say PA school is there "Backup" plan if they don't get into med school. I understand this is not the same case for you... but I would just be sure that your argument for "Why PA" is super strong given how competitive both med and PA schools are.
 
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Becoming a PA is not considered a stepping stone to an MD; they are 2 separate career paths. Pick one or the other.
 
You realize that, even after the debt, you'll have more money than most PAs as an MD, right? I mean, if the average PA has a working lifetime of 41 years at 100k/year, and the average physician has a working lifetime of 36 years at 200k, you're still making $4.1 million versus $7.2 million. Throwing away $3.1 million dollars because of 300-400k in debt is foolish.


This is a really important point that you should really, really consider. As an MD you will ultimately pay off the debt and you will come out ahead financially.

What you should be weighing more than the financial commitment is the time commitment. You'll have many more years of intense studying and brutal hours as an MD. That is worth it for many (I considered this seriously myself and decided it was worth it to me) but may not be worth it to you and it's perfectly fine if it isn't!

It's cliche, I know, but what ultimately made me decide medicine was a resident friend who shared the quote with me "medicine is only for those who could not imagine doing anything else."
 
The answer is pretty simple... unless you have a family and the breadwinner...
What choice will make you happy in 20 years? Will you look back with regret?

Here's a question I use (a bit morbid) when I face a big life decision:
"When I'm 80+ y/o (hopefully) and on my death bed (probably from cancer) - will this be something I regret? Will I be happy with the choices I made?"
 
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