Accepted MD, But Considering PA School

[negotioablenonstarter]

Hello all,

I am very fortunate to have been accepted to a US-MD program starting this summer. I have been working toward this for the past 7 years and I feel incredibly thankful that I have been given this opportunity.

The problem is, as matriculation grows nearer, I have found myself with feelings of doubt that I have not experienced before. This is not a doubt about the field of medicine as a whole, but rather which training path I have chosen. As I have grown older (I’ve been out of school for a couple years), my priorities have begun to shift (as do those of many people as they grow older). Because of this, I have begun to think about forgoing my MD acceptance to apply for PA school.

My considerations in this are listed below:

• I want to have started a family by the time I am 30 years old, and I actually want to be present for the first years of my kids’ lives (main concern with this is residency, I am 24 currently).

• I’ve also realized how important geographic mobility is to my happiness. I do not want to compromise on where I live because of job availability. Or if I do have to compromise on this initially, I want to be able to relocate mid-career if so desired without having to completely rebuild my practice from the ground up. Because PAs have the ability to work in any specialty given relevant experience, I would have many more job opportunities wherever I hope to live as a PA vs as an MD.

• Finally, I want the ability to use vacation time in chunks of 2-3 weeks at a time, with the option to take 1-2 months off on a rare occasion (maybe once every couple years).

A side note: This is not just some "in an ideal world" dream vision of mine where I am wishing for an easy job with no call or responsibility. There are real-world reasons/constraints in my life causing me to look for these things in my career. I'd rather not type my life memoir into this post so I will just leave it at that.


Please correct me if I am wrong, but to me it seems like becoming a physician assistant will be much more conducive to all of this. Does that sound like an accurate assessment?

I have considered the PA route heavily before, but have always decided that I want the full scope of training provided by an MD and residency program (hence why I went through the effort of applying). I still believe that, career-wise, I would be more fulfilled being a physician than being a PA. However, I am starting to question if the MD is worth it if I have to give up these other things that are also important to me. For me, fulfillment from work is only one piece of the puzzle. I don't really want to give up the other things just to maximize my satisfaction at work.

Perhaps some of this is coming from the fact that I am actually accepted now and I’m staring down the barrel of at least 7 years of training (likely more depending on specialty choice/fellowship). Call it cold feet if you will. But that does not change my feelings on what I want for my life outside of work. Despite how most of this post may sound, I truly am passionate about medicine, and I am astutely confident that I am going into healthcare for the correct reasons. I’m just also becoming much more weary of the lack of control that I will have over my life as a physician, especially in certain specialties.

If I stay the course and enroll this summer, what specialty options and/or practice models will allow me the autonomy in my life outside of work that I’m looking for? From all of the research I’ve done, it sounds to me like emergency medicine, internal medicine, or anesthesia are options that might provide me with the work-life balance I’m looking for, if nothing else but for the shift-work style scheduling that is common in these specialties. Locums could be an option too.

I would love to hear from any physicians and/or PAs that either have this kind flexibility in their careers, know somebody else that does, or can speak to how difficult it will be for me to build this type of life as an MD vs PA.




***EDIT***
Now that I've had some time to reflect on my feelings and all of the responses to this post, I am feeling much, much better about my future in medicine. I think this post originated from a mix of too much time on my hands, overthinking my future, and a bit of ignorance on my part in terms of the many styles of practice that physicians can work in. I know that taking the easy road short-term will leave me full of regret later on, and earning an MD is all I have ever been able to see myself doing with my life. It would be an utter waste of my effort and drive to throw that away just to be done with training earlier.

Thank you to everyone that helped to talk me off of this ledge. I am sometimes prone to letting my negative thoughts get the better of me, and I really needed this encouragement.

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[Lt.]

I don't have the credibility to answer exactly what you are looking for (not an M.D.) but I just felt the need to jump on this: please count your blessings and stay the course! You seem to have a good head on your shoulders, just from reading your post, and I imagine have the potential to be an excellent physician. It would be a shame to throw it away for concerns that may not be relevant/accurate. For example, I'm sure people will soon tell you it is indeed possible to have a family, be geographically mobile, and take vacations, if somewhat more difficult. I believe your priorities will remain a result of your priorities, if you will- that is to say, you will find a way to keep them at the forefront of your life whether you are a PA or an M.D. So let me be the first encouraging post to say keep going.

 

[Med Ed]

There is thinking, and there is over-thinking. There is planning, and there is over-planning. There is forest, and there are trees.

The big picture is that MD + license + board certification is a ticket to one of the most flexible career paths on the planet. Getting them is difficult, but it's an investment that pays off for the entirety of one's remaining life. A life that goes on long, long after next 7 years are a distant memory.

I assume you have been to the Nontraditional Students forum and read some modern classics like I am a Physician Assistant student regretting my choice and When is too late?

 

[Mr.Smile12]

Welcome to the forums.

Seven years working to get accepted to medical school. You have finally caught the car, and now you have buyer's remorse after all the work chasing the car. Maybe this is the first decision that you can't really go back on. Your concerns about starting a family will still be there regardless of what path you take, and hopefully those concerns were discussed as you were pursuing medicine with blinders on.

Students in medical school (including PA programs) start families while in training. You probably will find support wherever you go. You can do it if the support is there.

 

[Nontrad_FL_LGBT]

You are wise to have concerns along these lines. I don't think it's fair that people are just poo-pooing that.

I'm going to be 31 at matriculation if I get in my first try. I'm planning to start a family with my fiance; we're trying to have the pregnancy line up for a delivery around the middle of M4.

To support this, I am self-limiting to improve my QOL during the process. You can either grind hella hard and ignore friends and family, or have solid relationships and QOL without grinding as hard. Very few people are able to keep all those plates up at once. I'm only planning on applying to at the most medium-competitive specialties with FM and Psych being my top interests. I'm probably not going to do tons of away rotations unless we're financially in a position to co-travel.

You've already proven you can handle the pressure and meet expectations. Make a choice that will make you happiest, but grinding for 7 years? You want to be a doctor. Find a way to be a doctor that won't stress you out too much and enjoy the ride.

 

[fd25]

Hey! I’m an incoming M1 this fall too. I’ve always had the opinion that I love medicine and I’m so happy that I’m pursuing my MD, but I love my family and nothing will stop me from cultivating that too. I have a partner and together we have a daughter who is almost 5 (I am 25). I am planning to give birth to our second child during the first half of med school too.

Life is crazy and life is hard, especially in a career path like this. When you have a family and you have that support system around you, there are always ways to make it work. I’m lucky to have an incredible partner, and I will always actively make the choice to continue growing and developing my family despite the long, arduous path that I’m on. And I find solace in the fact that I have an amazing partner to fall on whenever I inevitably need her. You can do it too! You can achieve two dreams (family and medicine) at the same time. I believe that for me, it will be hard, but it will be worth it.

 

[soontobedoc98]

There is thinking, and there is over-thinking. There is planning, and there is over-planning. There is forest, and there are trees.

The big picture is that MD + license + board certification is a ticket to one of the most flexible career paths on the planet. Getting them is difficult, but it's an investment that pays off for the entirety of one's remaining life. A life that goes on long, long after next 7 years are a distant memory.

I assume you have been to the Nontraditional Students forum and read some modern classics like I am a Physician Assistant student regretting my choice and When is too late?

or DO + license + board certification

haha I Had to!

OP, your concerns are legit. But assuming you finish med school at 28, do a three year residency, you'll be done at 31. That's still more than fine! You've worked hard for this moment; don't think short term, think LONG term.

Where do you see yourself in twenty-thirty years?

 

[AlbinoHawk DO]

Either go big or go home. Midlevels get a lot of rightful judgment in today's environment because this shortcut leaves you unprepared. You only understand this if you're a doctor

 

[srirachamayonnaise]

PA over MD any day.

 

[negotioablenonstarter]

You are wise to have concerns along these lines. I don't think it's fair that people are just poo-pooing that.

Trust me, I expected to catch plenty of flack for this post haha. But I am thankful for those like yourself that have taken it seriously and gave a legitimate response to my concerns.

I'm going to be 31 at matriculation if I get in my first try. I'm planning to start a family with my fiance; we're trying to have the pregnancy line up for a delivery around the middle of M4.

To support this, I am self-limiting to improve my QOL during the process. You can either grind hella hard and ignore friends and family, or have solid relationships and QOL without grinding as hard. Very few people are able to keep all those plates up at once. I'm only planning on applying to at the most medium-competitive specialties with FM and Psych being my top interests. I'm probably not going to do tons of away rotations unless we're financially in a position to co-travel.

You've already proven you can handle the pressure and meet expectations. Make a choice that will make you happiest, but grinding for 7 years? You want to be a doctor. Find a way to be a doctor that won't stress you out too much and enjoy the ride.

This is all good to hear, you have lots to look forward to it sounds like. Yes, my SO and I have been talking about M4 or PGY-2 as good times to have our first kid as well. I'm sure there are plenty of others out there with similar goals in medicine. I think part of my issue is that the mentors I have had are very intense and take pride in the fact that medicine takes up 90% of their waking hours. Not saying that is a bad thing, quite the opposite. I find it incredibly inspiring. But (and this hurts my pride to admit, though I basically said as much in my OG post), I'm starting to realize that is not who I am. Which is okay I guess. I've just also seen several posts from other docs on this forum that give off the sentiment that if you aren't willing to make medicine the most important thing in your life for the majority of your 30s/40s, you would be better off letting a "more passionate" person take your seat and go to PA school instead.

Thanks for your input. My internal crisis has not fully abated, but this has been a very helpful glimpse into an alternative view of this career path. Best of luck to you in all of your endeavors.

 

[negotioablenonstarter]

I don't have the credibility to answer exactly what you are looking for (not an M.D.) but I just felt the need to jump on this: please count your blessings and stay the course! You seem to have a good head on your shoulders, just from reading your post, and I imagine have the potential to be an excellent physician. It would be a shame to throw it away for concerns that may not be relevant/accurate. For example, I'm sure people will soon tell you it is indeed possible to have a family, be geographically mobile, and take vacations, if somewhat more difficult. I believe your priorities will remain a result of your priorities, if you will- that is to say, you will find a way to keep them at the forefront of your life whether you are a PA or an M.D. So let me be the first encouraging post to say keep going.

Thank you friend. This was a great piece of encouragement to wake up to before heading to work.

 

[jhmmd]

Hello all,

I am very fortunate to have been accepted to a US-MD program starting this summer. I have been working toward this for the past 7 years and I feel incredibly thankful that I have been given this opportunity.

The problem is, as matriculation grows nearer, I have found myself with feelings of doubt that I have not experienced before. This is not a doubt about the field of medicine as a whole, but rather which training path I have chosen. As I have grown older (I’ve been out of school for a couple years), my priorities have begun to shift (as do those of many people as they grow older). Because of this, I have begun to think about forgoing my MD acceptance to apply for PA school.

My considerations in this are listed below:

• I want to have started a family by the time I am 30 years old, and I actually want to be present for the first years of my kids’ lives (main concern with this is residency, I am 24 currently).

• I’ve also realized how important geographic mobility is to my happiness. I do not want to compromise on where I live because of job availability. Or if I do have to compromise on this initially, I want to be able to relocate mid-career if so desired without having to completely rebuild my practice from the ground up. Because PAs have the ability to work in any specialty given relevant experience, I would have many more job opportunities wherever I hope to live as a PA vs as an MD.

• Finally, I want the ability to use vacation time in chunks of 2-3 weeks at a time, with the option to take 1-2 months off on a rare occasion (maybe once every couple years).

A side note: This is not just some "in an ideal world" dream vision of mine where I am wishing for an easy job with no call or responsibility. There are real-world reasons/constraints in my life causing me to look for these things in my career. I'd rather not type my life memoir into this post so I will just leave it at that.


Please correct me if I am wrong, but to me it seems like becoming a physician assistant will be much more conducive to all of this. Does that sound like an accurate assessment?

I have considered the PA route heavily before, but have always decided that I want the full scope of training provided by an MD and residency program (hence why I went through the effort of applying). I still believe that, career-wise, I would be more fulfilled being a physician than being a PA. However, I am starting to question if the MD is worth it if I have to give up these other things that are also important to me. For me, fulfillment from work is only one piece of the puzzle. I don't really want to give up the other things just to maximize my satisfaction at work.

Perhaps some of this is coming from the fact that I am actually accepted now and I’m staring down the barrel of at least 7 years of training (likely more depending on specialty choice/fellowship). Call it cold feet if you will. But that does not change my feelings on what I want for my life outside of work. Despite how most of this post may sound, I truly am passionate about medicine, and I am astutely confident that I am going into healthcare for the correct reasons. I’m just also becoming much more weary of the lack of control that I will have over my life as a physician, especially in certain specialties.

If I stay the course and enroll this summer, what specialty options and/or practice models will allow me the autonomy in my life outside of work that I’m looking for? From all of the research I’ve done, it sounds to me like emergency medicine, internal medicine, or anesthesia are options that might provide me with the work-life balance I’m looking for, if nothing else but for the shift-work style scheduling that is common in these specialties. Locums could be an option too.

I would love to hear from any physicians and/or PAs that either have this kind flexibility in their careers, know somebody else that does, or can speak to how difficult it will be for me to build this type of life as an MD vs PA.

I think that you're approaching this all wrong. Medicine is a calling. Doctors commit their lives to their work. If you approach this as, "What kind of career will best align with my lifestyle/values," then you're barking up the wrong tree, to be frank. If you want to be a doctor for the right reasons, you'll use your time management skills to fit in other things around it. And if those things don't work out, then at least you achieved your career goals and you won't regret it. It's a very simple matter of what is more important to you. So maybe you need to sit down reason through a pros and cons list, or something. Get it down on paper. Good luck.

 

[negotioablenonstarter]

There is thinking, and there is over-thinking. There is planning, and there is over-planning. There is forest, and there are trees.

The big picture is that MD + license + board certification is a ticket to one of the most flexible career paths on the planet. Getting them is difficult, but it's an investment that pays off for the entirety of one's remaining life. A life that goes on long, long after next 7 years are a distant memory.

I really appreciate your reply. Can you explain what you mean by "one of the most flexible career paths?" I guess the impression I have gotten from interacting with physicians (and from forums like sdn/reddit), is that that being a practicing physician really locks you down both geographically and in terms of time spent working, without much control over either. Not that I am going in planning on working part-time or anything like that, but I don't want to be averaging 60 hours/week, every week as an attending either.

I assume you have been to the Nontraditional Students forum and read some modern classics like I am a Physician Assistant student regretting my choice and When is too late?

I am familiar with such posts and others like it. I assure you that I do not want to be the next person making a similar post. Being a doctor has been a dream of mine for so long, and I have invested far too much time and effort into this to throw it away without absolutely rock-solid reasoning as to why I would be doing so.

 

[jhmmd]

I really appreciate your reply. Can you explain what you mean by "one of the most flexible career paths?" I guess the impression I have gotten from interacting with physicians (and from forums like sdn/reddit), is that that being a practicing physician really locks you down both geographically and in terms of time spent working, without much control over either. Not that I am going in planning on working part-time or anything like that, but I don't want to be averaging 60 hours/week as an attending either.


I am familiar with such posts and others like it. I assure you that I do not want to be the next person making a similar post. Being a doctor has been a dream of mine for so long, and I have invested far too much time and effort into this to throw it away without absolutely rock-solid reasoning as to why I would be doing so.

Sounds like you have your answer! 👍

 

[DOVinciRobot]

I’ve also realized how important geographic mobility is to my happiness. I do not want to compromise on where I live because of job availability. Or if I do have to compromise on this initially, I want to be able to relocate mid-career if so desired without having to completely rebuild my practice from the ground up. Because PAs have the ability to work in any specialty given relevant experience, I would have many more job opportunities wherever I hope to live as a PA vs as an MD.

See below.

• Finally, I want the ability to use vacation time in chunks of 2-3 weeks at a time, with the option to take 1-2 months off on a rare occasion (maybe once every couple years).

being a practicing physician really locks you down both geographically and in terms of time spent working, without much control over either

No.

Money, lifestyle, location.

Pick 2.

If location and lifestyle are a premium for you then a medical degree will give you that flexibility far more than being a PA. And you’ll still make more money than a PA.

I’m a junior resident and I get 5+ emails weekly for jobs. Some of which are “X 12hr shifts for the year to help considered full time” type gigs where people fly in for 2 weeks and then leave for 2 weeks. Not what most of us are looking for in surgery but if it’s what you want the opportunity is there.

I know ER doctors that literally fly across the country, do their 12 12hr shifts in a row, and then fly back to their primary residence the rest of the month. IM can do that same thing.

If job flexibility and lifestyle is what you want, then the MD is the choice. And not to mention even those “low paying” physician jobs still pay more than the PA ones.

 

[negotioablenonstarter]

I think that you're approaching this all wrong. Medicine is a calling. Doctors commit their lives to their work. If you approach this as, "What kind of career will best align with my lifestyle/values," then you're barking up the wrong tree, to be frank.

I take issue with this perspective. Yes you should be committed to your craft as a physician, I am not arguing that. You owe it to your patients to be absolutely committed. But the idea that this career must always take priority over other wishes in life is just a recipe for burnout. Many med students choose their specialty based specifically on "what kind of career will best align with my lifestyle/values."

I'll quote myself here:

I think part of my issue is that the mentors I have had are very intense and take pride in the fact that medicine takes up 90% of their waking hours. Not saying that is a bad thing, quite the opposite. I find it incredibly inspiring. But (and this hurts my pride to admit, though I basically said as much in my OG post), I'm starting to realize that is not who I am. Which is okay I guess. I've just also seen several posts from other docs on this forum that give off the sentiment that if you aren't willing to make medicine the most important thing in your life for the majority of your 30s/40s, you would be better off letting a "more passionate" person take your seat and go to PA school instead.

If you want to be a doctor for the right reasons, you'll use your time management skills to fit in other things around it. And if those things don't work out, then at least you achieved your career goals and you won't regret it. It's a very simple matter of what is more important to you. So maybe you need to sit down reason through a pros and cons list, or something. Get it down on paper. Good luck.

To address this point, I do agree with you that if I am truly passionate about medicine, I will make the other things I want fit around the career. I guess it is up to me to decide how to approach finding that balance.

Sounds like you have your answer! 👍

Not sure if I can responsibly call this internal debate over that easily (I owe it to myself and my future patients to get this decision right), but I am certainly leaning heavily in the same direction as all of the responses to this post. Thanks for your input.

 

[negotioablenonstarter]

PA over MD any day.

While I find your resolve inspiring, it may take a bit more substantiation of this claim to sway my decision hahaha

 

[jhmmd]

Well, maybe do some more mulling and come back to this thread. Again, good luck!

 

[srirachamayonnaise]

While I find your resolve inspiring, it may take a bit more substantiation of this claim to sway my decision hahaha

Here’s your own answer.

 

[Tenk]

I was 24 when I matriculated. I am a pgy-11 and patients still tell me I look like I’m in high school. You’re fine.

Also, to everyone mentioning locums. NEVER plan a career/specialty around locums. 1) the market is always fluctuating: price and contracts will change in an instant. 2) the places are usually dumpster fires. 3) when you actually add the 48 hours of two wasted days of travel to the hourly rate denominator, it usually isn’t that great.

 

[soontobedoc98]

I was 24 when I matriculated. I am a pgy-11 and patients still tell me I look like I’m in high school. You’re fine.

Also, to everyone mentioning locums. NEVER plan a career/specialty around locums. 1) the market is always fluctuating: price and contracts will change in an instant. 2) the places are usually dumpster fires. 3) when you actually add the 48 hours of two wasted days of travel to the hourly rate denominator, it usually isn’t that great.

PGY-11?? Dude what

 

[DOVinciRobot]

I think that you're approaching this all wrong. Medicine is a calling. Doctors commit their lives to their work. If you approach this as, "What kind of career will best align with my lifestyle/values," then you're barking up the wrong tree, to be frank. If you want to be a doctor for the right reasons, you'll use your time management skills to fit in other things around it.

Yeah.... no.....

PGY-11?? Dude what

Lol, it's a joke. PGY just means post graduate year so even attendings are technically PGY-something. My PD refers to himself as PGY-17 frequently

 

[negotioablenonstarter]

Money, lifestyle, location.

Pick 2.

If location and lifestyle are a premium for you then a medical degree will give you that flexibility far more than being a PA. And you’ll still make more money than a PA.

I’m a junior resident and I get 5+ emails weekly for jobs. Some of which are “X 12hr shifts for the year to help considered full time” type gigs where people fly in for 2 weeks and then leave for 2 weeks. Not what most of us are looking for in surgery but if it’s what you want the opportunity is there.

I know ER doctors that literally fly across the country, do their 12 12hr shifts in a row, and then fly back to their primary residence the rest of the month. IM can do that same thing.

If job flexibility and lifestyle is what you want, then the MD is the choice. And not to mention even those “low paying” physician jobs still pay more than the PA ones.

This is honestly the most reassuring response in this entire thread.

Not that I even know for sure that this type of practice will be what I aim for. Perhaps my feelings about these things will continue to change as I go through training. But knowing that there are at least options out there like this if I decide to more heavily prioritize location, lifestyle, etc. really does make a big difference in how I am calculating my decisions.

Like I said, in a vacuum, MD >> PA for me. I think the logistics of the career and the culture of never-ending work are what are causing these doubts to creep into my mind. There is definitely a point where planning for the future turns from a practical and wise use of headspace into a mess of overthinking and ruminating on details that are too far removed from reality/the present to hold any validity.

 

[negotioablenonstarter]

Hey! I’m an incoming M1 this fall too. I’ve always had the opinion that I love medicine and I’m so happy that I’m pursuing my MD, but I love my family and nothing will stop me from cultivating that too. I have a partner and together we have a daughter who is almost 5 (I am 25). I am planning to give birth to our second child during the first half of med school too.

Life is crazy and life is hard, especially in a career path like this. When you have a family and you have that support system around you, there are always ways to make it work. I’m lucky to have an incredible partner, and I will always actively make the choice to continue growing and developing my family despite the long, arduous path that I’m on. And I find solace in the fact that I have an amazing partner to fall on whenever I inevitably need her. You can do it too! You can achieve two dreams (family and medicine) at the same time. I believe that for me, it will be hard, but it will be worth it.

Congrats on your acceptance! You make good points. I am fortunate to also have an amazing and incredibly supportive SO, and that is really what is most important when thinking about the future w/ kids, careers, etc.

 

[soontobedoc98]

Yeah.... no.....

Lol, it's a joke. PGY just means post graduate year so even attendings are technically PGY-something. My PD refers to himself as PGY-17 frequently

LMFAOOOO I'm dumb. I thought he was doing some long residency hahahah

 

[negotioablenonstarter]

Where do you see yourself in twenty-thirty years?

That is so far away to my wee 24 y/o mind to think about haha. But truthfully at that point, I think I will at least want the option to chase bigger opportunities relating to my interests in my career. PAs certainly reach a ceiling earlier in their careers than MDs do, there's really no competition in that regard.

 

[soontobedoc98]

That is so far away to my wee 24 y/o mind to think about haha. But truthfully at that point, I think I will at least want the option to chase bigger opportunities relating to my interests in my career. PAs certainly reach a ceiling earlier in their careers than MDs do, there's really no competition in that regard.

Exactly. MD/DO gives a LOT of opportunity to leverage, network, etc. Both CAN offer cushy lifestyles based on specialty, but while the MD/DO route may take longer and with more stress, it is far more lucrative in the LONG-RUN.

 

[negotioablenonstarter]

Welcome to the forums.

Seven years working to get accepted to medical school. You have finally caught the car, and now you have buyer's remorse after all the work chasing the car. Maybe this is the first decision that you can't really go back on. Your concerns about starting a family will still be there regardless of what path you take, and hopefully those concerns were discussed as you were pursuing medicine with blinders on.

Students in medical school (including PA programs) start families while in training. You probably will find support wherever you go. You can do it if the support is there.

Your analogy is spot-on. The blinders in pursuit of this career are almost necessitated by the premed process. It has been a bit of a mental shakeup to transition from a blind pursuit to pausing and really thinking about my future in all aspects, rather than just my career.

I'm sure there will be plenty of options for support w/ my family should my SO and I choose to go down that road earlier rather than later. Is having a kid during medical school or residency what anyone would willingly choose if they had the option? Maybe some would, but all things being equal I'm sure most people would wait if possible. You are right that there will always be concerns about this stuff. Life isn't perfect, and there will be compromises. I am just wanting to make sure I'm not compromising in the wrong places. If I want the MD (which I really do), I will find ways to make the other stuff work with my career choice.

 

[deleted1079620]

Think of a PA like a forever resident. Ultimately, you’ll still have to follow the doctor’s plan, even if you’re supervised by an older doctor who perhaps isn’t as up to date on current guidelines & you may be. You won’t have to option to say “I know what’s best for my patient” because legally you’re required to be supervised.

As a doctor, once you’re past residency, you are the decision maker. While other doctors could read your notes & question your management, they can’t force you to change it. Some people are uncomfortable with this thought because it eliminates the safety net of someone double checking their work…that person should go PA/NP. But if you know you’d be frustrated not being able to ultimately call the shots & having the deepest knowledge, stick with the MD/DO.

Also, 24 is very young, even if it doesn’t feel that way. If you want to start a family by 30, you’re in a position to do that. Matriculating at 24 means you would be through medical school and mostly through residency by 30, if you chose one of the shorter ones like FM, IM, OBGYN, or anesthesia. Then you’re left with a career that still puts you over six figures even if you went part time while your children are little. PA salaries are around 150k, so if you went part time you’re only making 75k…is that worth being done sooner? Only you can answer that.

 

[Med Ed]

I really appreciate your reply. Can you explain what you mean by "one of the most flexible career paths?" I guess the impression I have gotten from interacting with physicians (and from forums like sdn/reddit), is that that being a practicing physician really locks you down both geographically and in terms of time spent working, without much control over either. Not that I am going in planning on working part-time or anything like that, but I don't want to be averaging 60 hours/week, every week as an attending either.

Physicians get locked down for a lot of reasons, but they generally have nothing to do with job opportunities. Spousal career, kids being in school, spending habits (aka golden handcuffs), extended family, etc.

While there are always exceptions, most specialties are in demand around the country, and there are literally thousands of different practice environments you could find yourself in, everything from a transplant team in a metro health system to telehealth from your dining room.

And if you decide you don't want to practice at some point, you can find a non-clinical gig. Get a MBA and do admin, work for pharma, work for a government agency, become a health writer, sell healing jerky on the internet, all these things are possible.

 

[deleted1079620]

I think that you're approaching this all wrong. Medicine is a calling. Doctors commit their lives to their work. If you approach this as, "What kind of career will best align with my lifestyle/values," then you're barking up the wrong tree, to be frank. If you want to be a doctor for the right reasons, you'll use your time management skills to fit in other things around it. And if those things don't work out, then at least you achieved your career goals and you won't regret it. It's a very simple matter of what is more important to you. So maybe you need to sit down reason through a pros and cons list, or something. Get it down on paper. Good luck.

I wish people would stop saying “medicine is a calling”, & making comments that anyone who is pursuing a career that aligns with their lifestyle/values is in it “for the wrong reasons.”

Medicine is a career. It’s not an identity, and no one should go into it prepared to sacrifice their mental or physical health or their relationships. We don’t expect nurses, PAs, NPs, teachers, lawyers, or computer programmers to forgo considering what quality of life they want to have while pursuing a career, so why do we expect it of doctors?

We’ve built a system that perpetuates a myth that if we aren’t subjecting ourselves to exhaustion & abuse that we somehow aren’t looking out for the needs of patients or we aren’t committed physicians. There’s absolutely nothing wrong with beginning with the end in mind, and choosing your path as you go so that it fits the lifestyle you want in the end. And that can still include a medical degree.

 

[Med Ed]

I wish people would stop saying “medicine is a calling”, & making comments that anyone who is pursuing a career that aligns with their lifestyle/values is in it “for the wrong reasons.”

Medicine is a career. It’s not an identity, and no one should go into it prepared to sacrifice their mental or physical health or their relationships. We don’t expect nurses, PAs, NPs, teachers, lawyers, or computer programmers to forgo considering what quality of life they want to have while pursuing a career, so why do we expect it of doctors?

We’ve built a system that perpetuates a myth that if we aren’t subjecting ourselves to exhaustion & abuse that we somehow aren’t looking out for the needs of patients or we aren’t committed physicians. There’s absolutely nothing wrong with beginning with the end in mind, and choosing your path as you go so that it fits the lifestyle you want in the end. And that can still include a medical degree.

Everyone looks at the profession a bit differently. The perspective of those who say it's a job/career is generally no less rigid than those who say it's a calling.

 

[Splenda88]

As attending who started medical school in my 30s, I would do it 1000x again. Plenty of available jobs; money and flexibility are great. For instance, can decide as hospitalist (IM) to work 1 wk on and 3 wk off, and my company will be fine with that. What I will make (165k/yr) working only 7.5 days on average every month will be more than what the average PA makes working FT.

In addition, I am kind of a prestige [insert]. For instance, 2-3 months ago, administration decided no midlevels are allowed in the physicians' cafeteria/dining room. No more free food, starbucks coffee snacks etc... for midlevels. That might not matter for some but it matters for a lot of people in medicine even if they don't want to admit it.

I was a RN for ~8 yrs and I have ZERO regret.

I have not given up anything. I work 7 days on/off from 7a-7pm but I am home by 5:30pm since I am allowed to leave work at 5pm (only has to answer calls until 7pm). I am off 15 days every month.

YOLO.

 

[negotioablenonstarter]

Added this to the OG post but here it is as a reply as well:

***EDIT***
Now that I've had some time to reflect on my feelings and all of the responses to this post, I am feeling much, much better about my future in medicine. I think this post originated from a mix of too much time on my hands, overthinking my future, and a bit of ignorance on my part in terms of the many styles of practice that physicians can work in. I know that taking the easy road short-term will leave me full of regret later on, and earning an MD is all I have ever been able to see myself doing with my life. It would be an utter waste of my effort and drive to throw that away just to be done with training earlier.

Thank you to everyone that helped to talk me off of this ledge. I am sometimes prone to letting my negative thoughts get the better of me, and I really needed this encouragement.

 

[srirachamayonnaise]

As attending who started medical school in my 30s, I would do it 1000x again. Plenty of available jobs; money and flexibility are great. For instance, can decide as hospitalist (IM) to work 1 wk on and 3 wk off, and my company will be fine with that. What I will make (165k/yr) working only 7.5 days on average every month will be more than what the average PA makes working FT.

In addition, I am kind of a prestige [insert]. For instance, 2-3 months ago, administration decided no midlevels are allowed in the physicians' cafeteria/dining room. No more free food, starbucks coffee snacks etc... for midlevels. That might not matter for some but it matters for a lot of people in medicine even if they don't want to admit it.

I was a RN for ~8 yrs and I have ZERO regret.

I have not given up anything. I work 7 days on/off from 7a-7pm but I am home by 5:30pm since I am allowed to leave work at 5pm (only has to answer calls until 7pm). I am off 15 days every month.

YOLO.

Yeah, hierarchy in medicine is not just palpable, but pulsating. Attending, fellows/residents, med student and then everyone else.

 

[Kuratz]

I know OP has already addressed everything but feel like the counter-perspective hasn’t been elucidated yet.

I’m a PGY4 and my wife is a PA. Her values are more in line with what you shared initially: family-centric, geographic mobility, and lifestyle. She has been able to easily have a family on our own terms, spend lots of time with our kids, and still be able to work some low-stress hours for objectively good money. In contrast I have been overworked and underpaid for the last 8 years with 2 still left to go. Despite being in a reasonably lifestyle friendly specialty (Rads) I still make major sacrifices and miss out on a lot. We have family in a HCOL area where physician salaries are lower. I’m fortunate in that telerads is a viable option to be able to live there but many clinicians are subject to the supply-demand and end up taking crappy jobs to move back. My priorities have shifted since having a family and I really wish I wouldn’t have gone this route. Not saying PA is necessarily better but just that the sacrifices don’t seem nearly worth it, and I’m not talking about the financial aspect. Time is far more valuable to me and it feels stolen all the time by this career. Perhaps in 10 years it’ll feel “worth it” when loans are paid off and I can actually afford to work less, but at this point I feel deeply injured by the abusiveness of the process. People on here are implying medical school and residency are some transient thing without fully conveying the major stresses and sacrifices you’ll make. And yeah, perhaps eventually you can cut back and still come out ahead financially but that’s after you pay off any loans and account for the opportunity cost. But at that point that’s a long ass road with a ton of work to immediately back down the hours. It’s really not a financial decision, anyway.

I think for someone who recognises their values of lifestyle and geographic flexibility early on then going another route is a totally valid and probably honestly a better proposition. I wouldn’t personally do medicine again (nothing in healthcare) and I know my wife would 100% do PA again because it suits her values. I think everyone coming on here and being supportive is fine but contrasts what I see in the real world which is a significant percentage of people totally unhappy with their decision to invest their lives into this.

Just think long and hard about it and don’t make a decision lightly based on a few posts on a forum. Talk to people in the real world and keep an open mind.

 

[negotioablenonstarter]

I know OP has already addressed everything but feel like the counter-perspective hasn’t been elucidated yet.

I’m a PGY4 and my wife is a PA. Her values are more in line with what you shared initially: family-centric, geographic mobility, and lifestyle. She has been able to easily have a family on our own terms, spend lots of time with our kids, and still be able to work some low-stress hours for objectively good money. In contrast I have been overworked and underpaid for the last 8 years with 2 still left to go. Despite being in a reasonably lifestyle friendly specialty (Rads) I still make major sacrifices and miss out on a lot. We have family in a HCOL area where physician salaries are lower. I’m fortunate in that telerads is a viable option to be able to live there but many clinicians are subject to the supply-demand and end up taking crappy jobs to move back. My priorities have shifted since having a family and I really wish I wouldn’t have gone this route. Not saying PA is necessarily better but just that the sacrifices don’t seem nearly worth it, and I’m not talking about the financial aspect. Time is far more valuable to me and it feels stolen all the time by this career. Perhaps in 10 years it’ll feel “worth it” when loans are paid off and I can actually afford to work less, but at this point I feel deeply injured by the abusiveness of the process. People on here are implying medical school and residency are some transient thing without fully conveying the major stresses and sacrifices you’ll make. And yeah, perhaps eventually you can cut back and still come out ahead financially but that’s after you pay off any loans and account for the opportunity cost. But at that point that’s a long ass road with a ton of work to immediately back down the hours. It’s really not a financial decision, anyway.

I think for someone who recognises their values of lifestyle and geographic flexibility early on then going another route is a totally valid and probably honestly a better proposition. I wouldn’t personally do medicine again (nothing in healthcare) and I know my wife would 100% do PA again because it suits her values. I think everyone coming on here and being supportive is fine but contrasts what I see in the real world which is a significant percentage of people totally unhappy with their decision to invest their lives into this.

Just think long and hard about it and don’t make a decision lightly based on a few posts on a forum. Talk to people in the real world and keep an open mind.

For me, this choice comes down to what I want my career and family life to look like in the long-term. I get that medical school and residency are more than just a “transient” part of my life, but if we’re talking about a career of 30-40 years, I’d rather be doing exactly what I want even if it does take me longer to get there. I have no illusions about the reality of working as a physician in the US, I know it isn’t all sunshine and rainbows once I graduate residency. This is something I will have to continue reflecting on, but I know I would forever regret not going the MD route, especially with how quickly I would run out of opportunities for advancement in my career as a PA. Life comes in seasons, and the child rearing season doesn’t last forever. I do want room to grow in my career and spend time on projects related to my interests in the field as I get older. That’s harder to find in a PA role. I am glad that you added this to the conversation though because this thread was definitely missing the opposing perspective.

 

[Yasha182]

Thanks for your post, I'm in a similar position with the same sentiments except I'm 28 and anticipate matriculating at 30-31. Also, I have no interest in having children. All the same it does not change the fear of missing out on youth in me. While my input might bear little weight, I encourage you to follow your dreams and I think you have already shown yourself you want to go MD by pursuing it for 7 years pre-matriculation already.

 

[srirachamayonnaise]

I know OP has already addressed everything but feel like the counter-perspective hasn’t been elucidated yet.

I’m a PGY4 and my wife is a PA. Her values are more in line with what you shared initially: family-centric, geographic mobility, and lifestyle. She has been able to easily have a family on our own terms, spend lots of time with our kids, and still be able to work some low-stress hours for objectively good money. In contrast I have been overworked and underpaid for the last 8 years with 2 still left to go. Despite being in a reasonably lifestyle friendly specialty (Rads) I still make major sacrifices and miss out on a lot. We have family in a HCOL area where physician salaries are lower. I’m fortunate in that telerads is a viable option to be able to live there but many clinicians are subject to the supply-demand and end up taking crappy jobs to move back. My priorities have shifted since having a family and I really wish I wouldn’t have gone this route. Not saying PA is necessarily better but just that the sacrifices don’t seem nearly worth it, and I’m not talking about the financial aspect. Time is far more valuable to me and it feels stolen all the time by this career. Perhaps in 10 years it’ll feel “worth it” when loans are paid off and I can actually afford to work less, but at this point I feel deeply injured by the abusiveness of the process. People on here are implying medical school and residency are some transient thing without fully conveying the major stresses and sacrifices you’ll make. And yeah, perhaps eventually you can cut back and still come out ahead financially but that’s after you pay off any loans and account for the opportunity cost. But at that point that’s a long ass road with a ton of work to immediately back down the hours. It’s really not a financial decision, anyway.

I think for someone who recognises their values of lifestyle and geographic flexibility early on then going another route is a totally valid and probably honestly a better proposition. I wouldn’t personally do medicine again (nothing in healthcare) and I know my wife would 100% do PA again because it suits her values. I think everyone coming on here and being supportive is fine but contrasts what I see in the real world which is a significant percentage of people totally unhappy with their decision to invest their lives into this.

Just think long and hard about it and don’t make a decision lightly based on a few posts on a forum. Talk to people in the real world and keep an open mind.

you will thank your old self when you have to pay for your kid's college tuition for doing the MD route. It's very clear that you don't like medicine and you are in it for the economic reason (which basically should never be the main reason for why anyone is in this business)

 

[dpmd]

Physicians get locked down for a lot of reasons, but they generally have nothing to do with job opportunities. Spousal career, kids being in school, spending habits (aka golden handcuffs), extended family, etc.

While there are always exceptions, most specialties are in demand around the country, and there are literally thousands of different practice environments you could find yourself in, everything from a transplant team in a metro health system to telehealth from your dining room.

And if you decide you don't want to practice at some point, you can find a non-clinical gig. Get a MBA and do admin, work for pharma, work for a government agency, become a health writer, sell healing jerky on the internet, all these things are possible.

Truth. I am general surgeon and I spend time with family, go on a lot of vacations (and time off for volunteer work I find rewarding), and could move any number of places if I wanted to. The reason I can is because I live within my means and decided that lifestyle was a priority for me over making the most money I possibly could. I still make many times what a PA would make and because of that I will be able to retire whenever I choose instead of having to keep working to support my lifestyle. Doctors who find they have to work harder and earn more to support their lifestyle chose to prioritize purchases and fancy things which is their prerogative but wouldn't work for me.

 

[jhmmd]

Truth. I am general surgeon and I spend time with family, go on a lot of vacations (and time off for volunteer work I find rewarding), and could move any number of places if I wanted to. The reason I can is because I live within my means and decided that lifestyle was a priority for me over making the most money I possibly could. I still make many times what a PA would make and because of that I will be able to retire whenever I choose instead of having to keep working to support my lifestyle. Doctors who find they have to work harder and earn more to support their lifestyle chose to prioritize purchases and fancy things which is their prerogative but wouldn't work for me.

This is basically what it comes down to. Medicine is a very lucrative industry. Any profession within the medical field is going to have a fairly cushy lifestyle, at least compared to everybody else. Relax and enjoy!

 

[Splenda88]

Thanks for your post, I'm in a similar position with the same sentiments except I'm 28 and anticipate matriculating at 30-31. Also, I have no interest in having children. All the same it does not change the fear of missing out on youth in me. While my input might bear little weight, I encourage you to follow your dreams and I think you have already shown yourself you want to go MD by pursuing it for 7 years pre-matriculation already.

I am not sure what you will be missing out on "youth"... Based on my experience, I would argue that med students on average travel and party more than the average person.

 

[Splenda88]

you will thank your old self when you have to pay for your kid's college tuition for doing the MD route. It's very clear that you don't like medicine and you are in it for the economic reason (which basically should never be the main reason for why anyone is in this business)

It should not be the ONLY reason but I would argue it should be one of the main reasons...