Considering career change to PA, advice?

[mousejunkie]

I posted about a month ago in the MD/DO non traditional forum, but as I have continued to research PA is looking like a more attractive option for me, and I would love to hear thoughts from people here.

I am 28, almost 29. I have a BA and MEd and work in the financial industry, no medical/healthcare background at all. A year ago when I was pregnant, I became a high risk pregnancy at 34 weeks due to unusual ultrasound results. Since then, my son has been in the NICU twice, has had skull surgery, seen MANY specialists, etc. At this point, he has an undiagnosed genetic disorder and we are waiting on exome results to help find a diagnosis (though we don't expect anything). This has really rocked our world. I could expound on it a LOT. Anyway, I have always had too much curiosity for my own good, so for the past year I've done nothing but research in my spare time. Not on WebMD, but reading actual medical journals and trying to decode them, spending hours reading the On Mendelian Inheritance in Man site (I'm too new to link, I guess) and ClinVar reading about different deletions and things like that...getting my son enrolled into research studies across the US, etc.

I have been both shocked and humbled by the number of families out there who deal with things like this. I feel very grateful we have flexible employers, family support, and just the wherewithal to know what questions to ask and what to research and how to advocate for our child. Many people don't have that. It has left me feeling like I could, and should, do more, and I have been thinking about changing careers for several months now. An MD in genetics was my first thought, because I believe the undiagnosed part of this ordeal has been the hardest for us, and if I could stop even one family from suffering through that, I would be thrilled. But I am also a realist, and I know MD geneticists fall on the low end of the pay scale. Neonatology is the other option I was looking into, but still, when I factor in the years of income/retirement savings I would lose, our age already, the fact that I don't want to miss my son's childhood for the sake of "helping" him (and others like him), I just don't know if it is worth it.

At first I wasn't considering PA as an option because from what I knew, they were generalists and more in family practice settings. However, looking into it more, I've seen that specialization is becoming more common. I know I want to be involved with kids who are similar to my son. I have seen that there are residencies for PA's in neonatology, and also just from looking at jobs in my area I see positions for pediatric orthopedics and pediatric craniofacial, which also appeal to me.

I guess the point of this post is just looking for people who know anything about these subspecialities? I haven't been able to find much here or else where online. Advice on other routes I should consider? Thoughts on the future of the PA profession? Or if I'm insane for even thinking about this. If I'm not...advice on how to get the patient-facing experience I would need (I'm thinking an ER scribe on Saturdays would be my best bet for now, but I really don't know). I can't quit my job right now, that's for sure. A PA just seems to be the most rewarding while also not stealing a decade of my life.

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[pamac]

There are many PA schools that will take you with minimal to no health care experience whatsoever. Every PA program has their own requirements for applicants to meet, and you just need to research different programs to see what you need to do to be a good candidate. If you are mobile, that will help, but it sounds like you might not be able to relocate easily.

I think PA would be the best match for you and your circumstances, but it still will take a significant amount of time away from your family. But I think the future of the profession is secure, even for folks that would like to work part time or other non typical shifts due to lifestyle factors. Unfortunately, PA school isn't cheap, so that makes immediate part time entry as a new grad fairly untenable. Loans come due, and the pressure will be on to make up for lost time.

I would suggest shadowing a PA, NP, or even a physician so you can get a little taste of what the real daily grind of being a medical provider involves. You mentioned that you would be thrilled to help "even one" patient through their ordeal, and the excitement of helping someone is rewarding, but you also mentioned the sacrifices that you and your family would have to make. I think that a lot of the drive you have is emotional. My hesitance towards encouraging emotional pursuits, especially ones as expensive as pursuing PA school, is that the reward comes at great cost and sacrifice, not to mention investment in time before you even would be on the front lines practicing in a way that you dream. And the reality of the work after that might not match up to your expectations. After achieving your goal, you will feel pressure to devote more time to your craft than you otherwise may want to... just because you will have debt and lost income to make up for. If you cut back on your workload, you may feel guilt about not using your opportunity to the max.

For everything that my patients think that I am doing in a given shift as an RN, they are typically mistaken. They see me in the room with them, interacting with them, laughing, consoling, guiding. They don't see 5 or 6 or more other rooms that I'm dealing with. They don't see the time I have to spend with documentation, or struggling with other staff, or trying to get someone to help with something. The few minutes of face time they have with me doesn't accurately represent the stresses I'm under, or the things I would rather be doing. One time I stepped in to help a patient in the ER who was cussing at me asking why their original nurse wasn't back with their medication, and the answer was that the young nurse had just dealt with a dead baby in another room, and after she was done there, she went out to the parking lot to throw up because she had a child the same age. But that particular patient had their own problems, and I politely deflected and got the med myself, and moved on. To that patient, I was Mr. nice guy who loved my job and got them their fix. They probably thought it made my day to help them. And to be sure, I didn't mind helping them, but I clocked in to get paid and support my wife and kids, and would have rather been giving a hug to my coworker, or even not seeing a dead baby and its distraught mother who looked like my wife.

I mention those things because becoming a PA might not be what you really want out of the valuable time you have with your family. I think people can find reward in whatever they do, and there are a lot of ways to make a mark on society that don't fit in to the notions that are culturally ingrained within us. If you are providing a good income with good security, and able to spend time with your family in an intact marriage, you are already doing most of what I'm hoping to obtain by finishing my NP degree. I am lucky because I don't mind doing my job, and I'm fortunate to be decent at what I do. I can't imagine doing anything else....not because I love it, but because I can't imagine that I could do anything else this well. But the fuel that feeds me is supporting my family, doing a good job at what I do, and further down the line is feeling self satisfied that I am helping someone. I'm realistic in knowing that most competent people can do what I do, and will do it if I'm not here. If I think I'm the only one that can do the job, that becomes an unhealthy illusion to me. Additionally, there are many folks that I really can't help as much as they need to be helped due to factors I can't control.

And I would suggest not getting into a career as a way to help a relative. As a relative, you really can't be objective enough to do a good job. They deserve to have someone treating them without our biases and fears getting in the way. By extension, the cases that cut close to my heart are also the ones that I really need to have distance from because I project my own fears about my relative on the patient that has similar issues. If I'm not careful, I'm sitting there dealing with my relative by proxy.

 

[mousejunkie]

Thank you for the in depth response! All good things to consider. I am worried about making this decision based on emotion, as that's the last thing I want to do. That's why I'm trying to explore all options and go very slowly and not jump into anything. I do ultimately feel something will need to change for me. I am old enough to know a job is a job (work to live, not live to work), but before this I have always at least been content going to work and enjoyed what I do, for the most part. That's no longer the case. I have realized I enjoy being in clinical settings. Obviously, I dread watching my son get poked and prodded and seeing him suffer, but I like talking to all the different providers about their experiences, watching the NICU nurses work at 3 AM and asking them what they're doing and why, being active on support groups and pointing people in the direction of research that might be applicable to their situations, etc. And I would be lying if I said it wasn't flattering when we take our son to a new specialist and I start on my list of questions and they ask me if I work in the healthcare field.

Time with family is definitely important, but I've never planned on being a stay-at-home parent or doing anything but working full time, so to some degree time away from family and some sacrifice is expected. My job in the financial sector is already pretty stressful but ultimately I feel like what I do does not positively impact the world at all.

Shadowing is my next plan for sure; I'm in a weird position in that I have contact with lots of the same doctors constantly but I don't know if asking them for advice/asking to shadow them or a coworker is appropriate. I don't want to blur the lines between patient caregiver and...something else.

Mobility would be somewhat of an issue, but it's more of an "I don't WANT to move" than we couldn't move. We are currently in Texas so fortunately it seems as though most of the schools in state do not have specific HCE/PCE guidelines. Past applying for all TX schools, the biggest thing I would look for were programs near a hospital system that had the specialty clinics my son needs. Luckily those usually go hand in hand with teaching hospitals.