direction?? MDA or CRNA ?

[psycho]

Ok... I am aware that there has been much debate about these 2 fields. My point is not to stir up more of the same. Rather, I seek any insights that you may be able to share with me as I'm feeling pretty indecisive re: which path to pursue.....

I am 31 yr old with a PhD in educational psych...always wanted to move into healthcare... took getting a PhD to realize that I probably could handle all the chem and physics if I tried
I have now taken all of the premed reqs., and now am in the throes of trying to work and prepare for the April MCAT ....

Having recently discovered the whole CRNA option, and having a real interest in anesthesia, I have begun questioning the need for me to do the whole med school thing. In the next 8 yrs I would like to have some children... and don't want to be away frmo home all of the time....

so here's my comparison of the 2 tracks do far... let me know if you have any additional pros/cons to add to my list (b/c if I'm not going to apply to med school... then I sure as heck want to stop prepping for the MCAT NOW!)

Am I correct in assuming that the CRNA track:
1. is well compensated and in the health care field
2. allows one to work when they want and how much they want (I?ve heard that 3 12 hour days are quite feasible)
3. able to function fairly independently (one guy I know works locum tenens, bills at $95 an hour? and pays a fraction of the liability that the MDA would as a locums guy (who is earning 150$/hr)
4. allow me to have more time to be at home with children

Are these valid comparisons? Would the MDA have longer hours all the way through? Are the part-time MDAs more limited in terms of position availability and compensation? (I had heard that they were more likely to be limited in terms of salary structure, etc). Is the liability that much more and compensation not necessarily that much more $ ? What have you heard re: salary comparisons b/t the two ? Is 120 v 180-200 a realistic comparison? Then again, is it true that the MDA might, in fact, be doing more supervision and less hands-on work himself? (so that the CRNAs end up being more the laborers of the operation?)

I hate to be asking all of these questions! But... my husband is fed up with my going around on this issue... and so I figured I'd try this forum out as a way to get some feedback...
As long as I?m unclear? I want to make sure that I know what I?m getting into?. Thanks for any help that you can provide!

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[VentdependenT]

Don't forget you will still have to go through nursing school and be a nurse for years (go shadow a nurse and see what its like to have that sort of patient contact). I believe you need 2 years of ICU work and they don't let fresh grads just jump into that unit. It takes experience = more years of working on the wards = pain. I personally think medical school would suit you considering your background.

With a Phd under your belt you may just want to go into academics or research. Probably easier to go about that by joining an academically heavy allopathic gas programs.

Check out the requirements to apply to CRNA school. They are available at any CRNA programs website.

 

[2ndyear]

Well, since you have done your premed prereqs you can probably get a BSN in 2 years. Now this can be bypassed from what I understand so long as you have a BS in some science (bio, chem, physics, etc.) and an RN. Getting an RN will still take about 2 years though. Add to this the minimum of one, possibly 2 years required as an ICU nurse. Now I'll admit I know little of nursing, but I would guess that new grads wouldn't be the first people I'd hire for the ICU jobs, and you may not want to jump into a setting like this. CRNA programs are 2-3 years in length, then you're done. Minimum time from now would be about 6-7 yrs.

If you can take the MCATS in the Spring, you can apply for med school now. 4 years + 4 years residency. As far as time in med school, you're obviously quite bright with a PhD. First two years are pretty much 9-5 or even less if you get PBL. Third year sucks for about 6 months on surgery and OB. 4th year is vacation. You can find a cushy intern transitional year where you'll only do 4 months of call. Residency you'll be busier in terms of call, but hours are somewhere around 60 on avg. Point is, the med school route isn't bad in terms of hours spent in class/on the wards as a whole. Don't worry about being 'older' or anything. We have 3 people in my class with PhD's, everything from engineering to philosophy. They all do very well.

Med school will give you more options. You may find that anesthesia doesn't appeal to you as much as say..radiology or peds or OB. You have that choice.

Anesthesiologists jobs vary a lot depending on the setting. In high volume surgical centers, sure they do supervision. In academic settings you can teach. The job will never become sole supervision though, too many big cases and sick patients exist. As far as salary, right now CRNA vs. MD is more like $120 vs. $300+. You get to join a group as an MD and get all of the benefits of that as well (bonuses, profit sharing, etc.). I don't demean to belittle CRNA's in any way when I say this, but it is more of a job from what I've seen. Very set schedule, 7-3 or whatever. Come in, do the work, go home. An MD will give you a career to practice, see the patient pre-operatively, have the opportunity to specialize and supervise. Do real research.

If you decide all you want is anesthesia and you want it quick, being a PA and then becoming an anesthesia assistant (AA) is probably the way to go. It is equal to the CRNA and geared more towards people with BS and/or PA degrees. You can find PA schools that will accept you with little in the way of clinical work. Lots use the MCAT for admissions. This program at Case Western doesn't even require PA school:
http://www.anesthesiaprogram.com
You can read more about AA's at: http://anesthetist.org/

 

[psycho]

Thanks for the great feedback! I have found a 1 yr accelerated RN program... which could shorten my path by 4-5 years (essentially the time for internship/residency)... still I like the idea of more options rather than less with an MD. My biggest hurdle right now seems to be taking the MCAT. I'm really in the midst of a mental block with respect to preparation... with work, etc.. all going on... coupled with angst about the test itself. It really is evil! If you have any further thoughts ... feel free to send them along...

 

[gaslady]

Getting an MD is hard work and comes with a lot of responsibility. There is great benefit to it and it's very satisfying. However, even though people talk about how hard it is, I didn't truly realize the sacrifices I was making until I got here. I have spoken to several other female interns about this as well and they feel similarly. You give up a lot. I'm not even ready to have kids yet , but I'm very scared because I know I will feel very torn between them and my career and feel unable to focus on either they way I would like.
If you decide to go to medical school you should do it because you feel compelled to and can't see yourself doing something else happily. If there is another route that you think will satisfy you, then that is probably the one to take. For you, it is important that if you do decide to go to med school that your husband understands what it entails and is supportive of that.

 

[deleted6669]

intersting factoid re crna's:
oregon jnust became the 11th state to exempt crna's from md oversight, making them independent providers of anesthesia services in the state.

 

[Leukocyte]

Originally posted by emedpa
intersting factoid re crna's:
oregon jnust became the 11th state to exempt crna's from md oversight, making them independent providers of anesthesia services in the state.

In my opinion, THIS IS NOT FAIR. How would the nurses/PAs or whatever feel if someone who is not in their profession came and took their job away from them. Medical School and residency are hard and require lots of sacrifices, and cannot be compared to a nurses education/experience. I do not care how much experience a nurse has to be a CRNA. He/She did not sacrifise as an MD/DO did to get were they are. He/She was WORKING and, Getting Paid, while the MD was and will continue to struggle with loans and the "lost" years of their young life.

IT IS JUST NOT FAIR TO MAKE A NURSE OR A PA TAKE THE JOBS AWAY FROM MD/DO ( NO MATTER HOW MUCH EXPERIENCE THEY HAVE).

PEACE.

 

[Leukocyte]

Sometimes I wonder, How many patients actually know that their anesthesia is administered SOLELY by a nurse without any supervision from the Anesthesiologist.

I wonder how the patients will react to that.

PEACE

 

[Brachial_Plexus]

Originally posted by emedpa
intersting factoid re crna's:
oregon jnust became the 11th state to exempt crna's from md oversight, making them independent providers of anesthesia services in the state.

Another interesting factoid..........the people of Oregon are now going to be subjected to receiving substandard anesthesia care. I wonder how they'll feel about that? In addition, the 11 states which currently exempt MD supervision aren't exactly desirable places to live.

Peace

 

[apma77]

this same topic has been beaten to death in other threads so please put this thread out of its misery

CRNAs are multiplying like termites and are going no where so deal with it...what our predecessors did by selling our specialty we must pay for in future thats the bottom line

 

[Tenesma]

there are mid-level practitioners in EVERY field of medicine... there are PAs doing ER, there are NPs doing Psych, etc... that trend will NEVER stop!!!

so just get over it - once you are done with your anesthesia training you will realize what separates you from a CRNA, and you will realize that your job opportunities haven't been lost... there will always be a need for us...

by the way, there are many CRNAs who can provide great anesthetics! so don't badmouth them - they got a masters degree for a reason... we can only bad-mouth the government and our fore-fathers who have allowed this to happen...

can we put this topic to rest, because honestly i am bored to death...

 

[juddson]

I know NM is one of them. My interviewer at CCLCM told me that. She also said that CRNA very much did threaten her practice (she is an MDA) and that played a part into going into academia.

Judd

 

[deleted6669]

OOPS..
There are now 12 apparently, not 11.....my bad

 

[antiadriani]

psycho-

If you want flexibility, go with the nursing option.

Also, while you are getting your experience in the ICU, you are getting paid. Leukocyte is right, my first year as an RN, I made roughly 70k (mind you it was in the Pacific Northwest which is a highly undesireable place to live aeb the recent opt-out decisions by two states).

You must be careful, however with this option, as if you are actually working, earning money, and living your found years of your young life, you may overlook what you can learn from your twelve hour shifts with the sickest patients in the hospital. Let me put emphasis on spending 12 hour shifts with the sickest patients in the hospital. You can learn a lot about critical care from top to bottom, but you will still be considered "half-baked" by the most respected in the hospital. You can reward yourself after this by choosing the CRNA option, or go to PA, or ARNP school if the anesthesiologists are too intimidating and territorial in your state. DO NOT DO THE AA route, THEY ARE NOT PAs! Currently this would limit your practice to a handful of states, and you would not be held accountable for your own practice. http://www.aapa.org/gandp/aas2.html

If you have the time, the patience, and do not have a problem with financing a damn good education, do the medical school route. As an anesthesiologist you would be held to the highest standard of care there is in anesthesia, as well as being confident that you have truly achieved the highest education.

As a CRNA I will always have to agree that I have never been to medical school...and frequently you hear the rationale "they do not know what they missed in their training, if they have not been through ours"

 

[antiadriani]

I have begun questioning the need for me to do the whole med school thing. In the next 8 yrs I would like to have some children... and don't want to be away frmo home all of the time....

....okay heres the plan.....get your nursing degree in the next 2 years(this should not be a problem for bsn if you have a phd already)....have your first kid in nursing school (this will be tough, but doable with supportive friends or family). Get in a good ICU fresh out of nursing school (there are units with new grad training programs). Get into CRNA school as soon as possible...most are between 28 and 35 months. Your first child will be 3 or 4, and you will be about 35 once you sit for board certs....if you are highly motivated, and have a lot of help you can have your children and get credentialed to be a CRNA as well. If you decide that you need to back out of the anesthesia thing all together, as you are enjoying the rewards of motherhood more than your career...fine, you are already an RN with a Phd, and will be highly marketable anyway.

One question? Would I still call you "doctor" if you were a nurse with a Phd?

That is the gameplan from a nursing perspective (I am a parent and a nurse anesthesia student)

Any of the docs out there have a good gameplan for her for the medical school route? (please do not say the aa thing again...okay fine, she can research it on her own time)

 

[MacGyver]

Originally posted by Tenesma

so just get over it - once you are done with your anesthesia training you will realize what separates you from a CRNA, and you will realize that your job opportunities haven't been lost... there will always be a need for us...

Short term you are right. But you need to think long term. MDAs will always be able to find jobs, but their incomes are about to take a huge plunge.

The issue is not MDAs being forced OUT by CRNAs YET.
The issue is how much can the MDA expect to earn when the CRNA can do the same job and be happy with lower pay.

My prediction: In 20 years, both CRNAs and MDAs will earn 100k or so.

 

[VentdependenT]

Is that with inflation MacG?

 

[antiadriani]

Pretty bleak salary Mac G, for MDA, especially considering all of your training. What do you think about driving it down even further with the addition of AAs? Lets control this downward spiral...you guys are the bosses, crnas are here to stay, and AAs are redundant.

 

[tahitian3]

Wow, this has got to be one of the most straight-forward, mature discussions concerning MDAs and CRNAs. I'm proud of you guys.
See how rational thinking and respect for others can lead to very interesting and informative conversations?
I've learned so much about the differences and similarities of these 2 professions from this one particular thread than I have from other posts on SDN in a long time.
Keep up the good work!