why not choose PA/ NP instead of MD since I start late

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immanuel11421

immanuel11421
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I am 32 years old now and planning to take mcat in January. I have been working fulltime and going to school to finish my pre-med fulltime. I have been very focus of wanting to go to med-school until recently of having thoughts of 'short-cut'.

For those of u who is also non-traditional student who has family and resposibilities for kids, would u share with me why u aim for MD? If u like medical field and want to help people, why not choose to be physician assistant or nurse practiotioner since we are late boomer and those other routes take less time?
I don't know if this sound pathetic. May be I am burnt out, I need to hear some compelling stories to be motivated and inspired again to aim for MD.
I am afraid that I will miss out on my family, I am afraid to find out I make mistake again. I had picked a career that I hated but I have done it for 10 years.
On the other hand, I don't want to listen to my husband and just pick the 'short-cut' and be PA/NP and while deep down I want to be a doctor. I will turn very bitter working under MD and want to be them.
I am confused. Would u share with me your stories, what make u want to be an MD and nothing else.
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Medical student here:

Become a PA....it is a much safer and practical thing for someone in your position. Do you really want to put yourself in that much debt and make no money in residency? A PA out of school will make more than a resident. Definitely do PA and stay away from medical school
 
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I'm not so sure about that, if she will be unhappy being an NP/PA, then maybe it's not right for her. To ask yourself "what if" for the rest of your working life is nothing short of depressing, really.

I'm working right now and already make a good living, but it has always been my dream to be a doctor. It's not about how much money I'll make, or how much time I'll spend in school any more. I found the medical field has made me more excited than anything else I have ever experienced before, and I hope that medicine will make me truly happy. I don't want to look back ten years later and wish I had gone to medical school then. OP, you may have already experienced that feeling at your current job, don't do it to yourself again.
 
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USARMYDOC

Since u are already a medical student, I want to hear your experience about why u said what u said.
Yes, I got previous pre-med classmate who is already in their rotation in PA program and said they already got offer a job 80k when they finish. They are teasing me about me still working in my shxxty job and still struggling with mcat.
But I thought in the long run, PA has a ceiling to their salary and doctor is still a better deal. It takes a long time but wouldn't it be more fulfilling as a doctor once u are done with your residencies?
I could be wrong, I want the truth.
The med-school debt is scary. The healthcare reform leave a lot of uncertainty. But I thought since PA work under doctors, if doctors doesn't get paid well and unhappy, PA will not do well eiher if their 'bosses' are having bad day. I could be very wrong, that's my projection from working in corporation.
I am open to hear all stories esp from people who are experienced.
 
For a long time I was planning on applying to PA school. To be honest it makes a lot of sense...the only problem was that I couldn't find it in me to find enthusiasm or passion toward this decision. Once I allowed myself to consider medical school it was like a new life was blown into me. Of course, that is only my outlook.

I considered other aspects of this decision beyond my feelings. The largest consideration was given that while I am not 100% sure what specialty I would like to practice, the majority of the areas I find myself interested in PA's do very little or only certain aspects of the job, and since this is my dream I don't want to be limited.

If you are 100% sure that you want to be a FP,IM, or EM then PA school may be a better route.

It's smart to think this over, and it's normal to wonder if this is worth it. For some it isn't worth it. Better to think it over now when you haven't invested as much. Good luck!
 
I share your fear and anxiety. However, I'm like you that I won't be happy working under someone else... My suggestion would be to do some volunteer work at a hospital to observe on different roles. If you still want to be a doctor, give it a try. If you can't make it, you still have an option to do PA. Either you succeed or not, at least you won't be thinking "what if... " and "I should have..." for the rest of your life.
 
We're old right. You run out of gas and think ****...this is a long haul. Or something like that.

The thing that counters all reasonablness to the contrary for this absurdist drama (for me) is that what will the last haul really look like.

40's 50's 60's maybe 70's maybe even a codgering 80 something before I quit or fall out dead. That's the real long haul. Working for decades in your chosen profession. I couldn't let it be chosen for me. By the brute force of circumstance. That would feel like a trap. I wouldn't make it.

So then it's Vegas or bust. With being a doctor. The midlevel role is not without swallowing the what ifs. Rare the person be that never pushes against that boundary with no thought of what if or I should've.

I have my doubts about anyone who's even having this conversation being content at 2nd fiddle.
 
echo523 said:
I share your fear and anxiety. However, I'm like you that I won't be happy working under someone else... My suggestion would be to do some volunteer work at a hospital to observe on different roles. If you still want to be a doctor, give it a try. If you can't make it, you still have an option to do PA. Either you succeed or not, at least you won't be thinking "what if... " and "I should have..." for the rest of your life.
Click to expand...

Not to rain on anyone's parade, but even as Dr.'s you will most likely still have someone over you. Even in private practice you will have the pressures of insurances companies to either do more tests or less tests depending on the situation and then you are the one fighting for reimbursement.

I believe that Dr's have more autonomy overall.
 
I have done volunteer work. Maybe not the right one. I volunteered in hospital in Brooklyn and I told them I want direct patient contact to maximize the 'experience'. I ended up getting abused by LPNs doing their dirty work while they chit chat.
Stupid nurses who got the nerve to blame me when she couldn't find her menu after I picked up lunch take out for her.
I learn nothing but really resent the LPNs and the nurses.
What's the right place to volunteer n maybe I should ask for different department?
 
immanuel11421 said:
USARMYDOC

Since u are already a medical student, I want to hear your experience about why u said what u said.
Yes, I got previous pre-med classmate who is already in their rotation in PA program and said they already got offer a job 80k when they finish. They are teasing me about me still working in my shxxty job and still struggling with mcat.
But I thought in the long run, PA has a ceiling to their salary and doctor is still a better deal. It takes a long time but wouldn't it be more fulfilling as a doctor once u are done with your residencies?
I could be wrong, I want the truth.
The med-school debt is scary. The healthcare reform leave a lot of uncertainty. But I thought since PA work under doctors, if doctors doesn't get paid well and unhappy, PA will not do well eiher if their 'bosses' are having bad day. I could be very wrong, that's my projection from working in corporation.
I am open to hear all stories esp from people who are experienced.
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I'll PM you.....but for those considering medical school and are on the "older" side think about the following....Lets say you are 28

1 year to apply
4 years of school
Minimum of 3 years of residency
-Working 70-80 hrs a week for $8-11/hr if you break it down.

You are now 36 years old with >$150,000 in debt and the future of healthcare is uncertain. I highly recommend PA. With Obamacare, 43% of physicians say they will retire early. That means more job opportunities for PA's. In addition, you will have the business savy students jumping into the business aspect of medicine which leads to even a higher physician shortage.

I know you have a ceiling with regards to pay & autonomy, but at least you are out of school when you are 30 making 70K and enjoying your life. You also do not need to worry about paying huge amounts of money for malpractice.

Disclaimer: This is only MY OPINION....sit down and think about what makes you happy
 
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FluffyRabbit said:
I'm not so sure about that, if she will be unhappy being an NP/PA, then maybe it's not right for her. To ask yourself "what if" for the rest of your working life is nothing short of depressing, really.

I'm working right now and already make a good living, but it has always been my dream to be a doctor. It's not about how much money I'll make, or how much time I'll spend in school any more. I found the medical field has made me more excited than anything else I have ever experienced before, and I hope that medicine will make me truly happy. I don't want to look back ten years later and wish I had gone to medical school then. OP, you may have already experienced that feeling at your current job, don't do it to yourself again.
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Valid point
 
Nothing personal against the physicians responding to this thread...and the dialogue is necessary....but...

A physician nullifies there position in this type of consideration by the nature of where they are.

Several physicians have taken me aside in attempt--well-meaning of course--to persuade me against the pursuit for all of the sane reasons that are indicated by the physicians here.

But there's just a small problem with that line of questioning. What would this advising group of physicians really have done differently. Would they have really become PA's. I think not. Not even if they said they would.
 
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immanuel11421 said:
I am 32 years old now and planning to take mcat in January. I have been working fulltime and going to school to finish my pre-med fulltime. I have been very focus of wanting to go to med-school until recently of having thoughts of 'short-cut'.

For those of u who is also non-traditional student who has family and resposibilities for kids, would u share with me why u aim for MD? If u like medical field and want to help people, why not choose to be physician assistant or nurse practiotioner since we are late boomer and those other routes take less time?
I don't know if this sound pathetic. May be I am burnt out, I need to hear some compelling stories to be motivated and inspired again to aim for MD.
I am afraid that I will miss out on my family, I am afraid to find out I make mistake again. I had picked a career that I hated but I have done it for 10 years.
On the other hand, I don't want to listen to my husband and just pick the 'short-cut' and be PA/NP and while deep down I want to be a doctor. I will turn very bitter working under MD and want to be them.
I am confused. Would u share with me your stories, what make u want to be an MD and nothing else.
Click to expand...
I am 33 and planning to take the mcat again. I score 27P on the first time I took it and I believe I can do better... therefore I am gonna take it again.. I am a RN now but I dont think my job stimulate my mind and I wanna do something in which I would enjoy more autonomy and that will stimulate my mind also... I am shooting for a 30+ in the mact so I can have a better chance to get an admission to DO schools because my GPA is not that great 3.1 cGPA and 3.5 BCMP... You have to see that way.. after you become a doctor you get to do what you love for at least 25 years if you get to live 65.
 
beckhunter116 said:
For a long time I was planning on applying to PA school. To be honest it makes a lot of sense...the only problem was that I couldn't find it in me to find enthusiasm or passion toward this decision. Once I allowed myself to consider medical school it was like a new life was blown into me. Of course, that is only my outlook.

I considered other aspects of this decision beyond my feelings. The largest consideration was given that while I am not 100% sure what specialty I would like to practice, the majority of the areas I find myself interested in PA's do very little or only certain aspects of the job, and since this is my dream I don't want to be limited.

If you are 100% sure that you want to be a FP,IM, or EM then PA school may be a better route.

It's smart to think this over, and it's normal to wonder if this is worth it. For some it isn't worth it. Better to think it over now when you haven't invested as much. Good luck!
Click to expand...

beckhunter116 said:
Not to rain on anyone's parade, but even as Dr.'s you will most likely still have someone over you. Even in private practice you will have the pressures of insurances companies to either do more tests or less tests depending on the situation and then you are the one fighting for reimbursement.

I believe that Dr's have more autonomy overall.
Click to expand...

Well... I know the Dr's are under some other supervision... However, PA's don't get to have the ultimate medical decision. If I'm looking for a "job" and the "money", then PA should be fine... but if you are someone is looking for more flexibility with time and more freedom and authority to do oversea work, you would need Dr degree.
 
This topic has been covered in other threads here in the non-trad forum, if you search you can find lots of conversations about every pro and con known to mankind.

Anecdotally, I am a medical student after working full time as an NP for over 5 years. I liked my job. Had SIX weeks paid vacation, made six figures and took very little call. You can only ignore your gut for so long, even if stepping out is seriously uncomfortable.

Nasruden is right. The 'what ifs' can eat you alive and I want to be able to look my wrinkly ole 60 year old self in the mirror and grin.
 
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Nasrudin said:
Nothing personal against the physicians responding to this thread...and the dialogue is necessary....but...

A physician nullifies there position in this type of consideration by the nature of where they are.

Several physicians have taken me aside in attempt--well-meaning of course--to persuade me against the pursuit for all of the sane reasons that are indicated by the physicians here.

But there's just a small problem with that line of questioning. What would this advising group of physicians really have done differently. Would they have really become PA's. I think not. Not even if they said they would.
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I enjoyed reading this. Thoughtful.
 
I am a non trad and single mother. yes I originally thought of PA for all the above reasons. However when I started to take the prereq that were the same for med school I started to reconsider. then when I started considering the flexibiltiy of a physician and the fact that I am bored with continually taking the short cut in life. Yes I will always have a boss (i defintely see myself working in a hospital) but it will not be me the PA or NP doing the work that is similar if not the same in some cases but still not being the doctor. The debt can be resolved there are always ways to reduce your student loans but how does one resolve the burning desire? I was the first to graduate college, obtain my masters and now I will be the first dr in my family and I did all as a High School drop out. This is why i can not be a PA or an NP.:):oops:
 
immanuel11421 said:
I am 32 years old now and planning to take mcat in January. I have been working fulltime and going to school to finish my pre-med fulltime. I have been very focus of wanting to go to med-school until recently of having thoughts of 'short-cut'.

For those of u who is also non-traditional student who has family and resposibilities for kids, would u share with me why u aim for MD? If u like medical field and want to help people, why not choose to be physician assistant or nurse practiotioner since we are late boomer and those other routes take less time?
I don't know if this sound pathetic. May be I am burnt out, I need to hear some compelling stories to be motivated and inspired again to aim for MD.
I am afraid that I will miss out on my family, I am afraid to find out I make mistake again. I had picked a career that I hated but I have done it for 10 years.
On the other hand, I don't want to listen to my husband and just pick the 'short-cut' and be PA/NP and while deep down I want to be a doctor. I will turn very bitter working under MD and want to be them.
I am confused. Would u share with me your stories, what make u want to be an MD and nothing else.
Click to expand...

You need to go with your heart. If you want to be a doctor then be a doctor. You will regret taking the "short cut" and not going for the gusto. I am an NP and wish I had started on this path instead and sooner. I am just happy I finally woke up and am doing what I always wanted in the first place. Being an NP or PA is not a "mini doctor" by any means. Been there, done that.....
 
southerngrl said:
You need to go with your heart. If you want to be a doctor then be a doctor. You will regret taking the "short cut" and not going for the gusto. I am an NP and wish I had started on this path instead and sooner. I am just happy I finally woke up and am doing what I always wanted in the first place. Being an NP or PA is not a "mini doctor" by any means. Been there, done that.....
Click to expand...

I guess you have a point but I think you should listen to what people currently in the situation have to say.

Good luck
 
2008orbust said:
This topic has been covered in other threads here in the non-trad forum, if you search you can find lots of conversations about every pro and con known to mankind.

Anecdotally, I am a medical student after working full time as an NP for over 5 years. I liked my job. Had SIX weeks paid vacation, made six figures and took very little call. You can only ignore your gut for so long, even if stepping out is seriously uncomfortable.

Nasruden is right. The 'what ifs' can eat you alive and I want to be able to look my wrinkly ole 60 year old self in the mirror and grin.
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AMEN!!!:thumbup:
 
Easy.

If the decision were about money I would have done sales, it is easy to make 100k + in sales.

Becoming an MD instead of a PA means you get to do a bit more and get paid a bit more, in the end it is more challenging.

To those who say PA, why not become a CNA (certified nurse assistant). It takes weeks instead of years and you get to work in the medical field.

Why even do the PA route?

If the only thing you guys are coming up with is "paycheck" then no matter what path you chose there will be problems.
 
One of the things about med school (especially if you have kids) is the amount of debt you'll be graduating with. It can be pretty debilitating.
KL
 
faith2 said:
I am a non trad and single mother. yes I originally thought of PA for all the above reasons. However when I started to take the prereq that were the same for med school I started to reconsider. then when I started considering the flexibiltiy of a physician and the fact that I am bored with continually taking the short cut in life. Yes I will always have a boss (i defintely see myself working in a hospital) but it will not be me the PA or NP doing the work that is similar if not the same in some cases but still not being the doctor. The debt can be resolved there are always ways to reduce your student loans but how does one resolve the burning desire? I was the first to graduate college, obtain my masters and now I will be the first dr in my family and I did all as a High School drop out. This is why i can not be a PA or an NP.:):oops:
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You make the best case for anybody to avoid the PA/NP route if they are worried about AGE/DEBT... at 33, I will not make the same mistake again when I chose the RN route in order to make "quick money" and keep saying later that I could have been a doctor... If becoming a physician is anybody dream, just go for it and dont let anything stop you. Now I can say for myself if it will take me fifteen years to become a physician, so be it. Debt and age are irrelevant for me now... I know that after I reach my goal in becoming a physician, I will be happy and strive to be a good one.
 
BennieBlanco said:
Easy.

If the decision were about money I would have done sales, it is easy to make 100k + in sales.

Becoming an MD instead of a PA means you get to do a bit more and get paid a bit more, in the end it is more challenging.

To those who say PA, why not become a CNA (certified nurse assistant). It takes weeks instead of years and you get to work in the medical field.Why even do the PA route?

If the only thing you guys are coming up with is "paycheck" then no matter what path you chose there will be problems.
Click to expand...

You get paid alot more especially if you specialize....Where I am starting for internal med is 150 and cardio 300.....both of those figures jump by 2x at least where I am.


You are comparing a PA to a CNA?!?!? I do not see your rationale is this at all. :confused::confused:

I love how everyone says its so easy to make 100K in sales.....ask all the people in sales who are out of jobs right now. It is not as easy as you think it is. Most people don't make it big in the business world.
 
echo523 said:
Well... I know the Dr's are under some other supervision... However, PA's don't get to have the ultimate medical decision. If I'm looking for a "job" and the "money", then PA should be fine... but if you are someone is looking for more flexibility with time and more freedom and authority to do oversea work, you would need Dr degree.
Click to expand...

I totally agree with you. I was just saying that there will be some supervision even as a Dr.
 
I saw three different doctors last month. The internal medicine and ob/gyn both tried talking me into doing PA/NP. The IM said she regrets her decision and wouldve done PA so she could start making money. They were both at a relatively nice, large practice.

The third one was at the county department of public health in a less than well-kept building and she said she absolutely loves her job and wouldn't trade it for the world.

At this point, i've heard all the cons from doctors, current med students, and current residents. And it might not be the best decision financially to go this route.

But I know myself well enough that if I don't go for it, the what if will eat away at me.
 
Like many of you, I thought this over a lot when I was considering going back to school.

I know a PA fairly well, and am impressed with the flexibility of his work. I met him when we were volunteering at a mission compound together. Then he spent about 2 years in the hospital in my town, then took off to South Africa for a couple of years. He can find work anywhere, but doesn't have to be tied down. I really thought I would go that route.

Then I looked at my personality and my work experience. It drives me crazy to have someone else know more than I do about something. I think it is very much an individual thing. In many fields a PA or NP will be doing the same job as the doctor, but the doctor has the science background they don't have. I really want that background. I love knowing how things work. If I had a second choice on a career, it would be in research, not in nursing. For someone like me, I don't anticipate having satisfaction from working as a PA.

I'm glad people are thinking about this, and there are a lot of valid points here. The malpractice is a big issue, and I imagine the difference in stress load between a doctor and a PA/NP makes up for the small difference in pay (assuming you don't specialize).
 
immanuel11421 said:
I am 32 years old now and planning to take mcat in January. I have been working fulltime and going to school to finish my pre-med fulltime. I have been very focus of wanting to go to med-school until recently of having thoughts of 'short-cut'.

For those of u who is also non-traditional student who has family and resposibilities for kids, would u share with me why u aim for MD? If u like medical field and want to help people, why not choose to be physician assistant or nurse practiotioner since we are late boomer and those other routes take less time?
I don't know if this sound pathetic. May be I am burnt out, I need to hear some compelling stories to be motivated and inspired again to aim for MD.
I am afraid that I will miss out on my family, I am afraid to find out I make mistake again. I had picked a career that I hated but I have done it for 10 years.
On the other hand, I don't want to listen to my husband and just pick the 'short-cut' and be PA/NP and while deep down I want to be a doctor. I will turn very bitter working under MD and want to be them.
I am confused. Would u share with me your stories, what make u want to be an MD and nothing else.
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Hello

I have been working as a Neurosurgical PA since 2002. Being a PA definitely has a lot of advantages but it also has number of limitations. As you go through your training, you will only skim the top of a subject. You will learn what and how but not a lot of detail on why. After you graduate and pass your boards, depending on your field and the trust you have with your supervising physician you may have a lot of autonomy but you will always be working under someone else. As more you learn and start formulating your own care plan, you will not be able to implement it unless your physician agrees. As a PA you will always be limited by your title and not by your knewledge or skills.

On the other hand, as a PA you have flexibility of choosing from countless fields, flexible hours, limited exposure to lawsuits and faster rout to practicing medicine.

I know a lot of PAs that are or have thought about going to medical schools, as well as those that want have nothing to to with medical school. I guess in the end it is your personal choice. As for me, I'm at a point in my career where being a PA is not cutting it anymore. My ultimate goal is to become a neurosurgeon. ;-) Best of luck to you.
 
BrainBox said:
As more you learn and start formulating your own care plan, you will not be able to implement it unless your physician agrees. As a PA you will always be limited by your title and not by your knewledge or skills.

.
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not always the case. if you work without a physician present in a primary care practice or rural emergency dept there is no one there to second guess you.
you make the plan, your team follows it through.I work solo about 1/2 the time now and no one has to sign off on my care plans. oversight is via distant chart review so if someone disagrees with something I have done( which hasn't happened at my current job in almost 10 yrs) they can't do anything about it. it's a done deal. That is not to say I don't get consults. of course I do just like any other provider who is an md/do/np/dpm/dds/etc
 
n3xa said:
I saw three different doctors last month. The internal medicine and ob/gyn both tried talking me into doing PA/NP. The IM said she regrets her decision and wouldve done PA so she could start making money. They were both at a relatively nice, large practice.

The third one was at the county department of public health in a less than well-kept building and she said she absolutely loves her job and wouldn't trade it for the world.

At this point, i've heard all the cons from doctors, current med students, and current residents. And it might not be the best decision financially to go this route.

But I know myself well enough that if I don't go for it, the what if will eat away at me.
Click to expand...

I will be 53 before I graduate from Med School if everything goes well. I could manage a PA at 51, maybe. I hope to stay working as a doctor for the following 20 years at some level.

Ok, so let's look at the difference - the PA will make ~80k for the rest of his life working full-time. He'll have to retire in his sixties because he won't be able to work those hours. The DO or MD will make 40k for 3 to 5 years working double time and then 150K+ the rest of his career working full-time and then make good money working part-time the rest of his non-disabled years. Both of them will pay off their student loans in 10 years making income-sensitive payments because they are working for a non-profit (new student loan rules).

The PA route makes no sense for anyone wanting to work into codger-hood on a least a part-time basis.
 
emedpa said:
not always the case. if you work without a physician present in a primary care practice or rural emergency dept there is no one there to second guess you.
you make the plan, your team follows it through.I work solo about 1/2 the time now and no one has to sign off on my care plans. oversight is via distant chart review so if someone disagrees with something I have done( which hasn't happened at my current job in almost 10 yrs) they can't do anything about it. it's a done deal. That is not to say I don't get consults. of course I do just like any other provider who is an md/do/np/dpm/dds/etc
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Good to have yout input.

But by your own description you clearly do not represent the norm. Most of us work in heavily bureaucratic, professionally saturated pyramids.

In this environment. To sandwich oneself in the middle of it as a PA? F that. I rather sweep the floors and have the mental space to write comic books in my head.
 
I invite anyone who is contemplating the MD/DO versus mid level to shadow and speak with a number of mid level practitioners. I do know that job satisfaction with Physician Assistant is the highest in health care with no other profession including physician even coming close. In short, PAs love what they do. If you want to be in this position, you have to understand and enjoy their scope of practice same as with any other health care career.

Length of time in training and cost of training take a backseat to actual enjoyment of any career. If you love what you do, then it isn't work. If you are looking for a quick and easy paycheck, I would argue that health care isn't an easy means to money regardless of field chosen.

I can also tell you that I have more training than most physicians practicing today (seven years in residency + two-year fellowship) and I started medical school later than most folks. I didn't look at my training as time spent in poverty but as training and education. Certainly having been through graduate school made me more able to live off of a lower salary but I can honestly say that I enjoyed medical school, residency and fellowship very much and was able to get the job done.

If you choose a career, mid level or not, you need to be thoroughly familiar with how the members of that field practice day in and day out. If physician assistants were not content with their scope of practice, they simply would have done something else (PA school isn't a "chip-shot" for folks who can't get into medical school these days). There is a reason why job satisfaction is so high for these folks and it might be that for people who are trying to make a decision to pursue medicine or not (and before you spend money on more tuition/testing fees) that you spend some quality time with a physician assistant and let them tell you why the like (or don't like ) their job.

Medicine is a long commitment to training before practice. If there is any possibility that you could be happy doing something else and length of training is an issue for you, then explore those options. If after your career exploration, you don't want to become a PA (or any other health care field), then medical school will certainly be there and as I have demonstrated, you can gain acceptance at an older age.
 
njbmd said:
I invite anyone who is contemplating the MD/DO versus mid level to shadow and speak with a number of mid level practitioners. I do know that job satisfaction with Physician Assistant is the highest in health care with no other profession including physician even coming close. In short, PAs love what they do. If you want to be in this position, you have to understand and enjoy their scope of practice same as with any other health care career.

Length of time in training and cost of training take a backseat to actual enjoyment of any career. If you love what you do, then it isn't work. If you are looking for a quick and easy paycheck, I would argue that health care isn't an easy means to money regardless of field chosen.

I can also tell you that I have more training than most physicians practicing today (seven years in residency + two-year fellowship) and I started medical school later than most folks. I didn't look at my training as time spent in poverty but as training and education. Certainly having been through graduate school made me more able to live off of a lower salary but I can honestly say that I enjoyed medical school, residency and fellowship very much and was able to get the job done.

If you choose a career, mid level or not, you need to be thoroughly familiar with how the members of that field practice day in and day out. If physician assistants were not content with their scope of practice, they simply would have done something else (PA school isn't a "chip-shot" for folks who can't get into medical school these days). There is a reason why job satisfaction is so high for these folks and it might be that for people who are trying to make a decision to pursue medicine or not (and before you spend money on more tuition/testing fees) that you spend some quality time with a physician assistant and let them tell you why the like (or don't like ) their job.

Medicine is a long commitment to training before practice. If there is any possibility that you could be happy doing something else and length of training is an issue for you, then explore those options. If after your career exploration, you don't want to become a PA (or any other health care field), then medical school will certainly be there and as I have demonstrated, you can gain acceptance at an older age.
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Take her advice....she is the person you want to listen to. Honestly, I do not think there is anyone on SDN who is smarter or more practical. :thumbup:
 
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Nasrudin said:
Good to have yout input.
But by your own description you clearly do not represent the norm. .
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True enough...probably 5% of pa's have the freedom that I do; those that work rural em and primary care. If I couldn't practice in this fashion I would go to med school so that I could. I left several of my early pa jobs due to too much nit picking and oversight and ridiculous impositions on pa scope of practice( at one job they didn't want pa's to start IV's but lpn's could- WTF, I was a paramedic for years before pa school and could run circles around most of the nursing staff in terms of emergent procedures....)
 
I really want to shadow a MD or PA/NP.
I work fulltime and this limit my schedule.
I had been volunteering in a neighbourhood hospital over the weekend but learn nothing about the profession I am interested in. They make me do all the LPN works and I have no contact with MD/NP or PA. The LPN kept me so busy with their work and I did not even get to abserve what the RN does.
I called up different hospital in Manhattan and they even a waitling list for volunteer in bigger hospital and some only have weekdays opening when I have to be at work.

Any advice on how can I shadow a physician or practitioner? I don't presonally have any friends who are MD or PA.
Should I keep going to certain physicians as a patient and then ask them if I can shadow them?
Is that awkward?
Thanks
 
USArmyDoc said:
You get paid alot more especially if you specialize....Where I am starting for internal med is 150 and cardio 300.....both of those figures jump by 2x at least where I am.


You are comparing a PA to a CNA?!?!? I do not see your rationale is this at all. :confused::confused:

I love how everyone says its so easy to make 100K in sales.....ask all the people in sales who are out of jobs right now. It is not as easy as you think it is. Most people don't make it big in the business world.
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The last 12 months before I went premed I earned 170k, most of my buddies (70%+) still doing what I did earn 100k pretty easy (right now). The #1 guy in the company doubled me up in income too. You are right that most don't earn this, but MOST suck at their jobs and MOST don't stay focused even 80% they are at their jobs.

I have to put up with more nonsense in premed (shadow/volunteer/classes/MCAT). When you work, all you have to do it work. A person who is an average sales person in a decent field can earn 100k with less nonsense than premed have to deal with.

If you work for a large company it is pretty easy.

My comparison was looking at working in medicine (CNA) vs working in medicine (PA). People's complaint is that it takes so long and costs so much to be a MD.

The shortest/cheapest path to working in medicine is a CNA.
 
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EdLongshanks said:
I will be 53 before I graduate from Med School if everything goes well. I could manage a PA at 51, maybe. I hope to stay working as a doctor for the following 20 years at some level.

Ok, so let's look at the difference - the PA will make ~80k for the rest of his life working full-time. He'll have to retire in his sixties because he won't be able to work those hours. The DO or MD will make 40k for 3 to 5 years working double time and then 150K+ the rest of his career working full-time and then make good money working part-time the rest of his non-disabled years. Both of them will pay off their student loans in 10 years making income-sensitive payments because they are working for a non-profit (new student loan rules).

The PA route makes no sense for anyone wanting to work into codger-hood on a least a part-time basis.
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The PAs in my area start at $78K and are at about $109K after five years. Some of the surgical PAs are bringing in $125K. On the other hand, some of the physician folks in Family Medicine and Peds are starting at $80K and maxing out at $125K. These numbers have definitely flipped which is why job satisfaction among PAs is quite high and MD/DOs are not as satisfied.

The expenses for medicine are much higher in terms of malpractice and other costs of opening office doors. Also, your performance in medical school and on boards will determine what specialty you will be able to enter. It's wonderful to believe that you are going to do exceptionally well and have your choice of specialties but more than half of the medical school class isn't going to come close to being competitive for a surgical specialty or the ROAD specialties and will be in primary care where the salaries are definitely lower.

You can also abandon the "I'll just work part-time" because part time doesn't pay for the malpractice insurance that you have to carry.
 
Nasrudin said:
Nothing personal against the physicians responding to this thread...and the dialogue is necessary....but...

A physician nullifies there position in this type of consideration by the nature of where they are.

Several physicians have taken me aside in attempt--well-meaning of course--to persuade me against the pursuit for all of the sane reasons that are indicated by the physicians here.

But there's just a small problem with that line of questioning. What would this advising group of physicians really have done differently. Would they have really become PA's. I think not. Not even if they said they would.
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I find many premeds in general to be miserable and unhappy with themselves. They don't enjoy medicine - they just need to one-up someone or something. They don't enjoy life... they're like preprogrammed to worry for the rest of their days. They would have been miserable in ANY career... it's just their personalities.
 
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njbmd said:
The PAs in my area start at $78K and are at about $109K after five years. Some of the surgical PAs are bringing in $125K. On the other hand, some of the physician folks in Family Medicine and Peds are starting at $80K and maxing out at $125K.
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$80k-$125k is a bit on the low side... you can make that working the lowest paying physician job you can find for the government and get 20 yr retirement while you're at it. You make more in the military... no clue where you got those numbers from :confused:
 
n618ft said:
I find many premeds in general to be miserable and unhappy with themselves. They don't enjoy medicine - they just need to one-up someone or something. They don't enjoy life... they're like preprogrammed to worry for the rest of their days. They would have been miserable in ANY career... it's just their personalities.
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I agree with you. There's a sickness in the culture. The career seems particularly brutal on those who shouldn't be there but just are...for the reasons you indicate.
 
Nasrudin said:
I agree with you. There's a sickness in the culture. The career seems particularly brutal on those who shouldn't be there but just are...for the reasons you indicate.
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100% true.

I just attended an awesome lecture by an ED physician who LOVES his job, he told us all the worst parts and what most people hated, and in spite of all that he loved his position and couldn't imagine doing anything else.

Both types of people are in all professions.
 
I agree with US Army Doc.

If I were 32 and applying, I would definitely pick PA over MD.
The institution of residency was designed for mid-20's with little familial responsibilities and commitments. In fact 20 years ago, surgical residencies would generally only recruit single men, not even married men. Do you really want that kind of lifestyle for 3 to 5 years making just over minimum wage?

By the time you get out of residency, you will be at least 39.
 
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I'm not sure I buy this notion of having to be a physician because nothing else will do. At the very least, it doesn't apply to me. I liked being a chemist, and I have spent plenty of time during medical school considering the possibility that I may have made the wrong decision. Looking back, I think part of it was the culture shock, part of it was the lack of ability to see where my niche in medicine might be, and part of it was the fact that I tend to spend a lot of time reflecting about my experiences, both good and bad. You tend to have an extreme number of both in medicine.

Ultimately, it is impossible to know if I made the "right" decision since I can't go back and do a controlled experiment wherein by this point I'm a tenure-track assistant professor somewhere. It would have been the safer decision to stay in chemistry, and it would have been easier, in the sense that I was already well down that path. But now I'm almost equally far down this path, and I have some idea of where I'm going to hopefully end up. Regardless of whether I made the intrinsically right decision (if you even believe that there is such a thing), I can make this decision into a right decision, or at the very least into a reasonably good decision. I can live with that.
 
n618ft said:
$80k-$125k is a bit on the low side... you can make that working the lowest paying physician job you can find for the government and get 20 yr retirement while you're at it. You make more in the military... no clue where you got those numbers from :confused:
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I agree, I don't buy that for a second. There are places in the country that pay much lower, but if a physician is getting paid $80k you can be sure that a PA isn't being paid more than that.

For reference:

http://www.bls.gov/oco/ocos074.htm#earnings

http://www.bls.gov/oco/ocos081.htm#earnings

I don't see how you can bend these curves to have PA above physician in any scenario, to be honest.
 
QofQuimica said:
I'm not sure I buy this notion of having to be a physician because nothing else will do. At the very least, it doesn't apply to me. I liked being a chemist, and I have spent plenty of time during medical school considering the possibility that I may have made the wrong decision. Looking back, I think part of it was the culture shock, part of it was the lack of ability to see where my niche in medicine might be, and part of it was the fact that I tend to spend a lot of time reflecting about my experiences, both good and bad. You tend to have an extreme number of both in medicine.

Ultimately, it is impossible to know if I made the "right" decision since I can't go back and do a controlled experiment wherein by this point I'm a tenure-track assistant professor somewhere. It would have been the safer decision to stay in chemistry, and it would have been easier, in the sense that I was already well down that path. But now I'm almost equally far down this path, and I have some idea of where I'm going to hopefully end up. Regardless of whether I made the intrinsically right decision (if you even believe that there is such a thing), I can make this decision into a right decision, or at the very least into a reasonably good decision. I can live with that.
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Interesting. However. To me. Your flexibility in finding contentment is a good doctor trait. Intrinsically you are in sinc with your choice. My experience squiring for docs is that a good number of them are ill suited to working in health care at all. Aside from their abilities. Disposition wise.

I think there is an intrinsic match between a profession and individual if only generally so. The culture of medicine does not do the best job of matchmaking for itself.

A cat can waltz into med school without ever seeing someone ****ting all over themselves in agony. Hands clean. What sense does that make. For a profession that serves the sick.
 
emedpa said:
True enough...probably 5% of pa's have the freedom that I do; those that work rural em and primary care. If I couldn't practice in this fashion I would go to med school so that I could. I left several of my early pa jobs due to too much nit picking and oversight and ridiculous impositions on pa scope of practice( at one job they didn't want pa's to start IV's but lpn's could- WTF, I was a paramedic for years before pa school and could run circles around most of the nursing staff in terms of emergent procedures....)
Click to expand...


You are right. PA's autonomy depends on the field. As a primary care PA working in rural setting, you are it. For me neurosurgery is my calling, so as you can imagine I have different scope of practice. Having said this, my autonomy depends on physician, case, situation and trust. For the most part, I function as a 3 or 4 year resident. When I started in 2002, I thought that this would satisfy me but now I'm certain that I need more. That is why I'm aiming to become a neurosurgeon.
 
Simplify said:
I agree, I don't buy that for a second. There are places in the country that pay much lower, but if a physician is getting paid $80k you can be sure that a PA isn't being paid more than that.

For reference:

http://www.bls.gov/oco/ocos074.htm#earnings

http://www.bls.gov/oco/ocos081.htm#earnings

I don't see how you can bend these curves to have PA above physician in any scenario, to be honest.
Click to expand...

those pa #s are actually low. last yrs survey of all working pa's found an avg of 86k. this #goes up about 2k/yr every yr.
2007 #s
http://physician-assistant.advanceweb.com/editorial/content/editorial.aspx?CC=108754
2008#s
http://physician-assistant.advanceweb.com/Article/PA-Salaries-by-Specialty-2008-2009-2.aspx
 
Nasrudin said:
Interesting. However. To me. Your flexibility in finding contentment is a good doctor trait. Intrinsically you are in sinc with your choice. My experience squiring for docs is that a good number of them are ill suited to working in health care at all. Aside from their abilities. Disposition wise. .
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I think that the key to me in the PA/MD-DO debate is the limitation. Once a person goes to PA school she will never be a medical doctor. There is no reasonable path from PA to MD. Someone will come up with a contrary example, but, if so, that would be the far-out exception. Almost no medical school will accept a PA as a student for obvious reasons.

I don't like being limited in what I can achieve. Alright, at my age its unlikely that I will ever be president, win the Nobel Peace Prize, or argue a case in front of the Supreme Court. People who do these things usually start younger in life. But, should the need and the occasion arise I CAN do any of these things while practicing as a doctor. But a PA will never rise higher than a PA. She will never be head of the emergency department or supervise other doctors. She will never earn as much as the doctors in her department. She'll never be the attending physician for anyone. I don't like "you can't" positions. They go against my grain.
 
EdLongshanks said:
I think that the key to me in the PA/MD-DO debate is the limitation. Once a person goes to PA school she will never be a medical doctor. There is no reasonable path from PA to MD. Someone will come up with a contrary example, but, if so, that would be the far-out exception. Almost no medical school will accept a PA as a student for obvious reasons.

I don't like being limited in what I can achieve. Alright, at my age its unlikely that I will ever be president, win the Nobel Peace Prize, or argue a case in front of the Supreme Court. People who do these things usually start younger in life. But, should the need and the occasion arise I CAN do any of these things while practicing as a doctor. But a PA will never rise higher than a PA. She will never be head of the emergency department or supervise other doctors. She will never earn as much as the doctors in her department. She'll never be the attending physician for anyone. I don't like "you can't" positions. They go against my grain.
Click to expand...

More or less me too. My mother is an NP. She and I have talked a lot about the professional dynamics and the personal.

For me it's mostly the constraints on my pursuit of and the practice of knowledge. It's not that I--if I was a physician--would ever hesitate to ask an experienced midlevel provider: "hey...what do you think about this..."

It's more like.... if there's a prick above me, making me eat it unnecessarily, I tend to look them in the eye so to speak. maybe too much and with a trouble maker's glare.

As a physician. The pricks will be more to my left and right. much more psychologically manageable for me.

I am not unwilling to take it for 8 years to get my situation right though. I anticipate that comment from physicians. Cause that's in their contract to go by the script.



I think njbmd said it good to the OP to talk to a half a dozen PA's or NP's.
 
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