At what age would you pick PA school over med school?

[Turkelton]

Going to medical school at practically any age can be a good decision if thats what you know you want. I was just hoping to get some opinions at what age would you personally not start medical school, and instead pursue PA school?

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[PharmBound2011]

generally it can be considered that if the comparison is between a typical FM/IM/PEDS physician and a PA, the PA will have made more money for the first 15 years of his/her career then the MD/DO. After that point the physician will begin to make more money then the PA ever can. This can vary significantly depending of the salary of the doctor (120k-999k). The comparison is made between a PA who has $60k of debt after 2 years of college and a physician who is $160k in debt after 4 years of college. The magic $45k salary during a 3 year residency. the salary of a physician was equated to $150k and the salary of a PA was equated to $84K.

This doesn't consider:
1) Physicians are in a higher tax bracket, thus lose some more $$ in taxes
2) Physician pays more $$ in interest
3) The dollars a PA makes early in his/her career is worth more then the dollars made later in one's career, as do Physicians.
4) The average PA will work 44 hrs/wk while the average primary care MD/DO will work 56 hrs/week. Thus, the difference in pay is less when $ per hour is considered.

Looking strictly at the monetary aspect, assuming retirement at 65, If someone is older then 45, it would make financial sense to go to PA school. If someone is younger then say 40, it definetely makes more sense to go to med school

That being said, a physician WILL still obviously make more money then a PA. If you specialize, then a doctor will be making more money then a PA as soon as 2 years out of college. This model is assuming strictly a primary care physician making $150k out of college, while the truth is most doctors that are in different fields make significantly more.

While this only considers the $$ aspect of it, other considerations are also important (autonomy, authority, respect)

 

[spiderpete]

2 points -

Although there are compromises with advancing age, plenty of docs are providing effective care well past 65. I am 48 and am counting on this being possible for me.

Degree of autonomy, authority and responsibility are also important factors in the choice between MD (or DO) and PA.

 

[avatarftw]

I would say 50. If you started med school at age 50, you would finish residency from 57-61. Even if you are very physically active with great nutrition, residency would be tough to undertake at such an older age.

The financial issue would make it even worse. If you can only practice for a few years with the debt and opportunity cost of medicine, its a very stupid financial decision. However, if you are financially independent and have money saved up, you can do it for other reasons.

Going to medical school at practically any age can be a good decision if thats what you know you want. I was just hoping to get some opinions at what age would you personally not start medical school, and instead pursue PA school?

 

[cabinbuilder]

I would say 50. If you started med school at age 50, you would finish residency from 57-61. Even if you are very physically active with great nutrition, residency would be tough to undertake at such an older age.

The financial issue would make it even worse. If you can only practice for a few years with the debt and opportunity cost of medicine, its a very stupid financial decision. However, if you are financially independent and have money saved up, you can do it for other reasons.

There was a lady in my medical school who started at age 51!! She waited untill all of her kids were grown and out. Her advantage was she paid cash for her tuition so she came out of it without any debt. Iif you can do it then the money factor really isn't an issue at all.

 

[nontrdgsbuiucmd]

I'd think part of the answer relates to what YOU want to do; with what level of autonomy would you be happy, and where do you want to practice? In a rural area, scope of work would be fairly similar between a primary care doc & pa overseen by a doc who visits that site a couple times per month to review charts; in an ER, the PAs work is overseen directly by a doc for every patient, so there's a bit less autonomy there.

Second part relates to the school; one admissions officer told me directly that, in general, a school is not going to choose to train someone who will complete their training near retirement age; therefore a 50 yr old applicant, per this admissions person, should NOT say they intend to pursue neurosurgery! Safer to say "undecided" or "leaning toward primary care". Oldest person in my class was around 47 when starting the first year.

 

[avatarftw]

The question is how long can she practice? She would have finished medical school at age 55 and residency at 58-62. I'm saying that it would be hard on the body to do long shifts at that age and unfortunately, one is much closer to death at that age...

There was a lady in my medical school who started at age 51!! She waited untill all of her kids were grown and out. Her advantage was she paid cash for her tuition so she came out of it without any debt. Iif you can do it then the money factor really isn't an issue at all.

 

[cabinbuilder]

The question is how long can she practice? She would have finished medical school at age 55 and residency at 58-62. I'm saying that it would be hard on the body to do long shifts at that age and unfortunately, one is much closer to death at that age...

So why is it anyone's right to judge? She was an EKG tech for 25 years and decided when it was right for her to go back and get an advanced degree to continue as an internist. So even if she works 15 years until 70 she is personally fulfilled and is still taking care of patients, albeit in a different manner. So in my eyes she really worked for 40+ years and was a productive member of sociey doing what she loved. It's up to the individual to decide whether the rigors of shift work is doable.

 

[Chevy Chase Fan]

I don't know, if you let in someone whose 50 and will likely only practice for maybe 15 years, it seems like a bit of a loss when you consider that you passed on several eager beaver 22 year olds that would have practiced for 3 times that long had they gotten in. I'm a non trad so I try not to think about that though, lol

 

[spiderpete]

I don't know, if you let in someone whose 50 and will likely only practice for maybe 15 years, it seems like a bit of a loss when you consider that you passed on several eager beaver 22 year olds that would have practiced for 3 times that long had they gotten in. I'm a non trad so I try not to think about that though, lol

Even if they don't mention it, this is a real concern for many Adcomms. The answer of course has to be that those years of practice will be more impactful because of prior experience.

 

[EdLongshanks]

Even if they don't mention it, this is a real concern for many Adcomms. The answer of course has to be that those years of practice will be more impactful because of prior experience.

I'm sure that it is a concern that the Adcomms cannot mention (for legal reasons) so I try to answer it even though they do not ask.

Firstly, I say, the 22 year old is probably not going to practice for 45 years. He is more likely going to retire early, or at least reduce his practice time to minimal in his early 50's. Secondly, I'm not going to retire early, if I was going to retire early, I would do that right now. So I'm going to practice for more than 15 years.

Secondly, I have the life experience to prove that I'm not going to be an average doctor, but a leader of the community who can do more than treat a few patients. So when you accept me, you are getting more than 20 average years of a doctor.

 

[spiderpete]

I'm sure that it is a concern that the Adcomms cannot mention (for legal reasons) so I try to answer it even though they do not ask.

Firstly, I say, the 22 year old is probably not going to practice for 45 years. He is more likely going to retire early, or at least reduce his practice time to minimal in his early 50's. Secondly, I'm not going to retire early, if I was going to retire early, I would do that right now. So I'm going to practice for more than 15 years.

Secondly, I have the life experience to prove that I'm not going to be an average doctor, but a leader of the community who can do more than treat a few patients. So when you accept me, you are getting more than 20 average years of a doctor.

Yep. Good answers.

 

[QofQuimica]

I don't know, if you let in someone whose 50 and will likely only practice for maybe 15 years, it seems like a bit of a loss when you consider that you passed on several eager beaver 22 year olds that would have practiced for 3 times that long had they gotten in. I'm a non trad so I try not to think about that though, lol

There's more to the calculus than how long applicants will practice. In fact, we (meaning the adcom) spend a lot more time thinking about putting together a good class, and not so much about how many years any of the students will practice. I'd argue that while we wouldn't want to have an entire class full of 50-year-olds, even assuming that we could, having nontrads in the class is valuable in and of itself because it adds to the general learning experience for everyone.

There is a famous paper that talked about the "hidden curriculum" in medical education. What the author is referring to is the idea that when we go to medical school, we acculturate into the professional norms of medicine. This is an implicit process. One of the reasons why diversity is so valued in medicine now is that we understand better how important it is to have those norms set by people with multiple backgrounds and perspectives, and not just white, upper-middle-class trad males.

Basically what we are seeing is an attempt to change the culture of medicine with the goal of providing improved care (and greater access to care) for all segments of our society. As nontrads, you and I are a part of that process. 🙂

Oh, and to answer the OP's question, at no age would I ever have considered going to PA school. Not because there is anything wrong with being a PA, but a PA degree is just not useful for a career in academic medicine.

 

[wholeheartedly]

I definitely think you can't rely just on years practiced for this. Using someone's example above, the eager beaver 22 year old might not have enough life/real world experience to realize what they're getting themselves into. The 50 something EKG tech has spent more time in the hospital and had plenty of time to learn about the downsides of medicine. (I'm only 2 years into my job and have really learned a ton about this) That 22 year old might wind up frustrated and leave the field or retire early, and the 50 year old might find herself fulfilled and more dedicated the practice of medicine. Of course it could go the other way too. I just think it's a bit unrealistic to make assumptions on the number or quality of years based on age alone. There's so much more that goes into that. I'm not anywhere near 50, nor will I be when I start practicing (hopefully) but I'm definitely not someone who plans on retiring early or even at 65 if I can help it. I might shift gears and change my focus like from practicing full-time to teaching/research and more community service type practice, but not slow down or stop.

 

[avatarftw]

All fine and dandy that you want to practice until 65+, but you don't have the OPTION of working as many years as the ~29-33 year old fresh out of residency. If you get out of residency at age 63, for example, you're relatively close to the end of your life. Most of us won't live until 90, for example. (heck, even 80)

Also, I don't know of a lot of doctors that practice when they are 65, 70. I don't know of any studies but many doctors have told me that its usually ~60 when they retire.

I definitely think you can't rely just on years practiced for this. Using someone's example above, the eager beaver 22 year old might not have enough life/real world experience to realize what they're getting themselves into. The 50 something EKG tech has spent more time in the hospital and had plenty of time to learn about the downsides of medicine. (I'm only 2 years into my job and have really learned a ton about this) That 22 year old might wind up frustrated and leave the field or retire early, and the 50 year old might find herself fulfilled and more dedicated the practice of medicine. Of course it could go the other way too. I just think it's a bit unrealistic to make assumptions on the number or quality of years based on age alone. There's so much more that goes into that. I'm not anywhere near 50, nor will I be when I start practicing (hopefully) but I'm definitely not someone who plans on retiring early or even at 65 if I can help it. I might shift gears and change my focus like from practicing full-time to teaching/research and more community service type practice, but not slow down or stop.

 

[spiderpete]

All fine and dandy that you want to practice until 65+, but you don't have the OPTION of working as many years as the ~29-33 year old fresh out of residency. If you get out of residency at age 63, for example, you're relatively close to the end of your life. Most of us won't live until 90, for example. (heck, even 80)

Also, I don't know of a lot of doctors that practice when they are 65, 70. I don't know of any studies but many doctors have told me that its usually ~60 when they retire.

All true. But then we all also know of docs who practice into their 80s. We also know that doctors are needed. Now. And those going into medicine relatively late in life are odd/exceptional/different ( you pick). There is a tremendous drive to make a difference and experience to back it up. Medicine will continue to change at an accelerating pace. People who can adapt in mid life to ride and drive that change should be welcome companions.

 

[LifetimeDoc]

You'll honestly get more respect as a PA. Doctors treat med students and residents like crap, especially nurses. You'll train for more years and not be able to do anything worthwhile for 7-9 years. As a PA you can be on the ground running in just a couple years.

 

[Prncssbuttercup]

You'll honestly get more respect as a PA. Doctors treat med students and residents like crap, especially nurses. You'll train for more years and not be able to do anything worthwhile for 7-9 years. As a PA you can be on the ground running in just a couple years.

More respect from who? I haven't yet seen a PA in the ER I volunteer in get more respect than the Drs working there. I have also seen PAs as a patient, and I would say that I still have more respect for the Drs, and it's pretty harsh to say that drs treat med students/residents like crap. Maybe some do, but certainly not ALL.

For the rest of this, I think you have to know whether you'd be happy as a PA and not a Dr, because in your interview they're going to ask why you aren't considering med school as an option. I was considering PA school, and then realized I wouldn't be happy in that role, so I went back to my original plan of med school

 

[n3xa]

More respect from who? I haven't yet seen a PA in the ER I volunteer in get more respect than the Drs working there. I have also seen PAs as a patient, and I would say that I still have more respect for the Drs, and it's pretty harsh to say that drs treat med students/residents like crap. Maybe some do, but certainly not ALL.

This.

Between my experience as a volunteer in the ER and shadowing a general surgeon in the OR at the same hospital, you'll do just fine if you "stay hungry and act humble." Sure, there are some real sour puss characters out there, but you gotta be able to shake it off.

Staying hungry and acting humble has gotten me in good with the surgical techs and nurses. They're all really sweet to me and I've seen them get nasty to other pre-med hopefuls who come into the OR acting like a total asshat to everyone else but the attending.

I have respect for those that work hard, know their stuff, and can talk to patients.

 

[carl414]

I've been having this same debate with my wife about PA vs. MD/DO. I'm a visual learner so I decided to spend an afternoon developing a spreadsheet to better understand the financial discrepancies over a 25 to 30 year career. Here is a link http://www.yourfilelink.com/get.php?fid=581760 to the file. Obviously your numbers will change, but these were the numbers that would apply to me. Let me clarify my numbers.

First, I assumed a 6% interest on my cumulative student loans. I also assumed a generic 4% annual salary increase. I also assumed a $25,000 student loan reimbursement for the first two years for serving in an under served/rural environment. I gave an extra year for premed undergrad as well vs. PA undergrad. Anyway, if anyone has any questions about my spreadsheet I'd be happy to explain as best I can.

 

[EdLongshanks]

I've been having this same debate with my wife about PA vs. MD/DO. I'm a visual learner so I decided to spend an afternoon developing a spreadsheet to better understand the financial discrepancies over a 25 to 30 year career. Here is a link http://www.yourfilelink.com/get.php?fid=581760 to the file. Obviously your numbers will change, but these were the numbers that would apply to me. Let me clarify my numbers.

First, I assumed a 6% interest on my cumulative student loans. I also assumed a generic 4% annual salary increase. I also assumed a $25,000 student loan reimbursement for the first two years for serving in an under served/rural environment. I gave an extra year for premed undergrad as well vs. PA undergrad. Anyway, if anyone has any questions about my spreadsheet I'd be happy to explain as best I can.

I'm real interested in your file, but could you place it somewhere else besides a peer-to-peer network. There is no way I will install that on my machine.

 

[NAVY ROLE 3]

I will not settle, MD or DO school for me! I don't care if I'm 50.😎

 

[Prncssbuttercup]

I've been having this same debate with my wife about PA vs. MD/DO. I'm a visual learner so I decided to spend an afternoon developing a spreadsheet to better understand the financial discrepancies over a 25 to 30 year career. Here is a link http://www.yourfilelink.com/get.php?fid=581760 to the file. Obviously your numbers will change, but these were the numbers that would apply to me. Let me clarify my numbers.

First, I assumed a 6% interest on my cumulative student loans. I also assumed a generic 4% annual salary increase. I also assumed a $25,000 student loan reimbursement for the first two years for serving in an under served/rural environment. I gave an extra year for premed undergrad as well vs. PA undergrad. Anyway, if anyone has any questions about my spreadsheet I'd be happy to explain as best I can.

I asked my friend who is currently in her 3rd year of residency this question. I did similar calculations, basically, I'll make W as a PA with X debt for that education, and I'll make Y as a doc and have Z debt. The thing was, when she told me my numbers were so far off on my salary assumptions for the Doc, I went back on my decision. We all know that PA education will run between 50-100k, and med school will run 80-300k (obviously there are extremes, and this isn't inclusive), the difference is that a PA will never make anywhere close to what a doc starts at, and you're assuming it will take you a full 30 years to pay back loans. She will have her loans paid off in 2.5 more years. The lifetime earning of a doc is so much higher than a PA that you would honestly have to be about 5 years from retirement before you started. Her salary per year as a general hospitalist is higher than her total loans including undergrad. Also, your paybacks for rural depend on the state. In MN, they will only pay ~20k/yr for 3-4 yrs, while CO will pay WAY (WAAAAY) more than that. Personally, I was having reservations about being happy as a PA, and after my discussion on financials with her, I was back to the original plan. I am not sure where the assumption is that you only make 45k/yr as a resident... she made 45$/HR (35, 45, 50 for 1st, 2nd, 3rd yrs)

 

[BLKPA2MD]

I asked my friend who is currently in her 3rd year of residency this question. I did similar calculations, basically, I'll make W as a PA with X debt for that education, and I'll make Y as a doc and have Z debt. The thing was, when she told me my numbers were so far off on my salary assumptions for the Doc, I went back on my decision. We all know that PA education will run between 50-100k, and med school will run 80-300k (obviously there are extremes, and this isn't inclusive), the difference is that a PA will never make anywhere close to what a doc starts at, and you're assuming it will take you a full 30 years to pay back loans. She will have her loans paid off in 2.5 more years. The lifetime earning of a doc is so much higher than a PA that you would honestly have to be about 5 years from retirement before you started. Her salary per year as a general hospitalist is higher than her total loans including undergrad. Also, your paybacks for rural depend on the state. In MN, they will only pay ~20k/yr for 3-4 yrs, while CO will pay WAY (WAAAAY) more than that. Personally, I was having reservations about being happy as a PA, and after my discussion on financials with her, I was back to the original plan. I am not sure where the assumption is that you only make 45k/yr as a resident... she made 45$/HR (35, 45, 50 for 1st, 2nd, 3rd yrs)

..You'll be disappointed if you're going into medicine for the money.

 

[Prncssbuttercup]

I was thinking about it in the same context that the OP was, I'm a non-trad, wouldn't finish until 40-something or later, and didn't know if it made financial sense, I never said I was in it for the money. You clearly read a lot into my post. I hear all the time about people whining about residents getting paid "crap" for money, I guess I don't consider 45$/hr crappy money... But I'm from the midwest, and maybe my opinion is different, I also didn't have rich parents like many students I meet... And to be truthful, no one is going to turn down the money... so, you can't tell me that it isn't on the list of people's motivations... it may not be the primary reason, but unless you've won the lottery, or your family has so much money you don't really need to work and this is for fun or glory, money in this country is a reason... Don't kid yourself

 

[cabinbuilder]

Also, your paybacks for rural depend on the state. In MN, they will only pay ~20k/yr for 3-4 yrs, while CO will pay WAY (WAAAAY) more than that.

DO NOT COUNT on state loan repayment. I have been in Colorado for the last 1.5 years and I am still trying to get student loan help. I applied to the NHSC and all three colorado state programs - was turned down for all of them and I have been in rural parts of the state the entire time. That is Obama-care at your service. If the money is out there, it sure isn't coming my way. Hmmmm😕

 

[deleted6669]

I guess I don't consider 45$/hr crappy money...

residents don't make 45 dollars/hr they make 45 thousand/yr.(some less).

 

[Prncssbuttercup]

residents don't make 45 dollars/hr they make 45 thousand/yr.(some less).

So, then my friend, whom I've known for 17 years, is either an anomaly or she lied? If she says people are wrong about the residency pay, I am inclined to believe her...

 

[EdLongshanks]

So, then my friend, whom I've known for 17 years, is either an anomaly or she lied? If she says people are wrong about the residency pay, I am inclined to believe her...

The residency pay is well-known and a published fact. You might have misunderstood your friend.

On the other hand, one resident told me that he moonlighted for $100/hr at emergency rooms. He made $140k the previous year - which might work out to $45/hour for long hours.

 

[Prncssbuttercup]

The residency pay is well-known and a published fact. You might have misunderstood your friend.

On the other hand, one resident told me that he moonlighted for $100/hr at emergency rooms. He made $140k the previous year - which might work out to $45/hour for long hours.

That is possible... I didn't misunderstand, she told me she sits on FB at the hospital waiting for calls and gets paid 50$/hr

 

[deleted6669]

pick any residency at random. go to their website. they all list pay by pgy yr.
for example ventura county, called by many the best fp residency in the country, has this salary schedule( I just checked):
pgy1 46k/yr
pgy2 51k/yr
pgy3 56 k/yr

and those are for 80 hr weeks....that's around 12 bucks/hr as an intern...

your friend may have been talking about their moonlighting rate as mentioned above...not the same thing as their resident salary

 

[ChE04]

That is possible... I didn't misunderstand, she told me she sits on FB at the hospital waiting for calls and gets paid 50$/hr

Sounds like she is moonlighting at a low acuity hospital. That is a whole separate paycheck from what you receive from your residency program.

Edit: oops guess I'm late on bringing this up! Note to self. Finish reading thread before responding...

 

[jl lin]

All fine and dandy that you want to practice until 65+, but you don't have the OPTION of working as many years as the ~29-33 year old fresh out of residency. If you get out of residency at age 63, for example, you're relatively close to the end of your life. Most of us won't live until 90, for example. (heck, even 80).

What you talking bout chinoco? I plan on working until I'm 90. Then I plan on living a fews years after that. . .like a number of folks in my family. 🙂 🙂 😉

Also, I don't know of a lot of doctors that practice when they are 65, 70. I don't know of any studies but many doctors have told me that its usually ~60 when they retire.

Hmmm. I do. Just curious. How many people that age do your interact with (besides in the hospitals and clinics) --I mean personally--that are that age???? Think about it.


If you think folks in ,pdy fields can afford to retire at 65 and 70 anymore, whoops. . .think again.

Good reason not to smoke, watch your drinking and eating, and exercise.

Unless you have some great plan for launching a second career, working PT, doing cool volunteer work etc, what the heck is so great about retiring???? Who the heck wants to sit around waiting to die--or just play golf or kick around the house all day every day?

Sorry. That's not for me. I'm not close to retiring; but even if I were, I just can't see it. I've seen more than a few people retire, get depressed, and then die not too long after retirement. My dad was one. He retired at 62. His wife didn't want to do any of the things he had planned--lots of travel, etc. He gave into her. He had his own kids and family--and we always loved being with him--doing things with him, but we were busy with jobs and family and school and such. Well, I truly believe depression and state of mind and emotions effects immunity in a very negative way.

So long story short, he gets this horrible leukemia dx. His wife talks him into limiting his treatment options, and within a little over a year after his retirement, he dies--after working like a dog for 46 years of his life.

So in general, I don't have good things to say about retirement, much less early retirement--and I think 62 was way too early. My father was always a young whatever age he was. It's really a shame.

 

[DucoNonducor]

I would not go the PA route. I've talked to PAs who thought it was a great idea then and now they regret it because all along they wanted to be physicians.

I thought about the PA/NP route but the bottom line is that I'd be trying to go through those routes just to get to being as close to a doctor as possible. That's why I just decided to purse the MD.