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auguy13

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Hey clinicians,

I have just graduated college with a B.S. in microbiology. I have been accepted to medical school but deferred my seat for one year due to serious second thoughts. To be honest applying to medical school may have been a premature pride move for me. It is a serious time/money commitment. My main concern is that I have no serious direction on what type of medicine I would like to practice. Everyone has said that's okay you will find something etc., but I worry about being locked into one field that may lose my interest after awhile. Every physician job I have shadowed interests me because it is new and exciting.

So my main question is for the PAs/NPs. How easy is it to switch areas of medicine that you work in? Say could I work in the ER for some time, then find a job at an HIV clinic or hospitalist. Or could I easily relocate for my spouse's job and land a job doing any area of medicine until something "more fun" comes my way. Money/feeling like the chief is not my main priority. I am simply just interested in medicine and healthcare. Without the constraints of being "trapped" or the liability of being the one in charge, I may function better/happier. I have seriously considered applying for PA/ accelerated NP programs. Not that getting in or the schooling will be easy. I respect every position in healthcare but don't know where I fit. Thoughts?
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auguy13 said:
Hey clinicians,

I have just graduated college with a B.S. in microbiology. I have been accepted to medical school but deferred my seat for one year due to serious second thoughts. To be honest applying to medical school may have been a premature pride move for me. It is a serious time/money commitment. My main concern is that I have no serious direction on what type of medicine I would like to practice. Everyone has said that's okay you will find something etc., but I worry about being locked into one field that may lose my interest after awhile. Every physician job I have shadowed interests me because it is new and exciting.

So my main question is for the PAs/NPs. How easy is it to switch areas of medicine that you work in? Say could I work in the ER for some time, then find a job at an HIV clinic or hospitalist. Or could I easily relocate for my spouse's job and land a job doing any area of medicine until something "more fun" comes my way. Money/feeling like the chief is not my main priority. I am simply just interested in medicine and healthcare. Without the constraints of being "trapped" or the liability of being the one in charge, I may function better/happier. I have seriously considered applying for PA/ accelerated NP programs. Not that getting in or the schooling will be easy. I respect every position in healthcare but don't know where I fit. Thoughts?
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What's with all the folks that are accepted to medical school bailing on it? I'd jump at the opportunity. Deferring a year only sets you back another year from being done.
 
IMO, it doesn't sound like the OP wants it badly enough. He's probably made the right decision.
 
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Blue Dog said:
IMO, it doesn't sound like the OP wants it badly enough. He's probably made the right decision.
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That is true. Getting to the point of being accepted is such a mountain to climb that it seems like the lack of resolve would manifest further back.
 
pamac said:
That is true. Getting to the point of being accepted is such a mountain to climb that it seems like the lack of resolve would manifest further back.
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This is how I feel. If I were accepted to medical school right now I do not think I would go. Too much work, too much time. I'm much happier with my current plans and prospects. I'm not surprised at all that others are seeing the appeal of the PA or NP route.
 
AnnoyedByFreud said:
This is how I feel. If I were accepted to medical school right now I do not think I would go. Too much work, too much time. I'm much happier with my current plans and prospects. I'm not surprised at all that others are seeing the appeal of the PA or NP route.
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If I had an acceptance in hand to a 3 yr program today I would go....
 
AnnoyedByFreud said:
This is how I feel. If I were accepted to medical school right now I do not think I would go. Too much work, too much time. I'm much happier with my current plans and prospects. I'm not surprised at all that others are seeing the appeal of the PA or NP route.
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I appreciate the path I'm on as well, but that's because I'm invested in it at this point, so going to an additional 4 years of school and 3 years of residency don't appeal to me. But dial back the clock a bit to when I was an undergrad, and if I had a shot at medical school (my grades weren't good enough, but this is a mental exercise), then it's a different story. I'd have hated medical school, I'm sure of it. Might have even disliked residency and the early years of practice, but I have a hard time thinking that 7 years of training would have been a bad deal compared to everything else I've done to this point. Heck, if the op does NP school, it's going to be 3 years at least, then you are a newby looking for a job. But med school, despite it's difficulty, is a good opportunity. If you are right there looking at a seat, then that's different than me looking at it having gone to med tech school, spending time in grad program, and having completed nursing school. But all that adds up to close to 5 years, so obviously im not interested in extensing things out 7 years at this point.

If I had landed a spot at my top choice pa program, I'd have had a real hard time turning it down, even though I'm much more satisfied with where I'm headed right now. When i got into nursing school, I ditched the other PA school interviews I had on deck because I knew which program was the one PA program I was willing to go to, and they told us pretty quick who they wanted to attend there. I love working as a nurse, and love the opportunity the NP degree will provide, so im happy the tides took me this direction. So i guess I look at it this way: i can sit here and say that it's good that I don't have a winning lotto ticket worth millions, because it would change me for the worse to have all that unearned luxury at my fingertips.... But that would just mean that I wouldn't be a good steward of what I've been given. Similarly, if medical school would make me into an unhappy person, then that just means I lack the fortitude I should already possess. So sitting with a seat in hand for me would be difficult for me to personally turn down.... For me. But then again, that can be seen as a big cop out because I dont have that acceptance letter to 7 years of struggle staring me in the face either. It's different when it's your free time on the line. If I could go back in time, I wouldn't do anything different, but if I had done things different, and had an acceptance to medical school, I would have taken it.

If it comes down to what seems to be making me satisfied right now, then yes, the money is good where I'm at in relation to what I feel I need, and I look forward to starting NP school next year sometime. I don't want to be a doctor. They impress me, but so do astronauts. I'm fine with my plan.
 
Very interesting replies. If I could go back in time, then maybe I would feel differently. Like, if I could go back to undergrad I may have done pre-med (instead of focusing on psychology and research) and focused on medicine. Or knowing what I know now maybe I would have done a BSN, worked in an ICU, and be in CRNA school now. Hmmm. It's hard to say. However, at this point in my life, the idea of going to medical school for four long years (not even considering that I"d have to do premed, take the MCAT, etc.), then residency, etc., definitely does not appeal. Glad I'm doing nursing, but then again, psych is its own weird beast and as far as I can tell, the psych NPs I know are very happy in their careers and don't really feel the stress of the "hierarchy" that I know can get to some NPs and PAs over time.

eta: And now I have Cher stuck in my head. "If I could turn back time..."
 
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AnnoyedByFreud said:
Very interesting replies. If I could go back in time, then maybe I would feel differently. Like, if I could go back to undergrad I may have done pre-med (instead of focusing on psychology and research) and focused on medicine. Or knowing what I know now maybe I would have done a BSN, worked in an ICU, and be in CRNA school now. Hmmm. It's hard to say. However, at this point in my life, the idea of going to medical school for four long years (not even considering that I"d have to do premed, take the MCAT, etc.), then residency, etc., definitely does not appeal. Glad I'm doing nursing, but then again, psych is its own weird beast and as far as I can tell, the psych NPs I know are very happy in their careers and don't really feel the stress of the "hierarchy" that I know can get to some NPs and PAs over time.

eta: And now I have Cher stuck in my head. "If I could turn back time..."
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Like I mentioned.... I wouldn't go back and do anything different, but if things were different, id have made different choices. Medical school never really appealed to me much, and I couldn't get myself to be really excited about either that or dental school (my original ideal career). The thought of practicing podiatry really put me in the dumps. Once I oriented myself towards PA school, I started to get jazzed about the field, and nursing started to peek through once i was exposed to it more. One of the things I'm glad for is that I didn't land my top choice pa program, because I would have taken it at the time. It would have removed me out of my home, and away from a job I loved. Financially, it wasn't a good match, and I could see that right before I interviewed. You tend to overlook things like that because of the effort made to get there. There's quite a few other things that made the nursing route a clear favorite for me, but about half of them were things I didn't forsee. But yeah... The return on my investment for nursing in terms of time and money has been really good. And right now I'm working 3 days a week, and it ain't bad. No debt. NP school will put me back in the ringer a bit as far as time goes when it starts, but I'm used to that (worked full time through nursing school). But, I'll probably never own a pool, boat, cabin, and RV all at the same time like a few of the physicians I know. I'll probably have to pick one of those things, or maybe two if I'm really lucky.... None of those things if my kids cost a bunch (which they probably won't because I plan to keep them pretty grounded). But my wife and I look at more stuff as being more things to keep track of, so we like to live as light as we can. I'm pretty stoked that I get like 26 PTO days a year (that's a ton when you work 3 days a week), time off at the drop of a hat (per diem workers lined up to fill in), decent bennefits, decent respect. Nursing has tons of positions apart from the roles most folks are familiar with. If you get burned out by patient care, you have tons of options that don't involve the daily grind that puts you on your feet lifting. Then there's the NP field available as well. A lot of folks are understandably concerned that they will feel like a small fish among all the doctors, and it's probably true that there could be some envy. Docs can seem to have it really good, but I tend to not see life as a peeing contest, and it doesn't chap my hide to see folks higher up the totem pole to me. I go to work to do what I do well. If I was a doctor or a janitor, I'd be working hard at either of those things and hold my head up.

I always look at medical school through the lens of what it takes to get through it and then to on to pay off the bills. Spread out the wages you earn after residency over the time it took to get to that point, and it probably comes down to like 15 bucks an hour. Even the 40k or so you make in residency a year comes out to 20k a year when yiu factor in that you work 80 hour weeks. Then there is the residency match that you have no ultimate control over, as well as the relocation where they tell you to go. Of course, the bottom line looks lower because we generally look at the hard numbers and just see the actual debt. But factor in lost income, interest on debt, time spent training that could have been spent working, then on to personal things you miss out on because of devotion to coursework.... I'm honestly surprised that medicine appeals to folks. I'm grateful it does, because humanity needs well trained doctors. But even with the prospect of decent income once medical training is completed, you then sacrifice freedom further because you have to start earning money to make those sacrifices worthwhile (not to mention start paying down debt and providing comfortably for your family). That brings its own kind of pressure. You face being tied down. I can pick up and move almost anywhere in the nation. A physician has resources and opportunity, but it takes a lot to compel an established doc to pick up and leave what they have once they set down roots. There's a few specialties that may find it easier than others.

Everybody has a boss, whether it's a supervisor, a debt load, a spouse's financial expectations, a reputation, a successful practice, health concerns....you dot get to be above everything.
 
pamac said:
Everybody has a boss, whether it's a supervisor, a debt load, a spouse's financial expectations, a reputation, a successful practice, health concerns....you dot get to be above everything.
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Absolutely agree. And I too am surprised by how appealing medicine is to people. I see how the med students, interns, etc., kill themselves working so hard, not sleeping, for years on end. It's a tough life and I understand how after going through medicine one would not want to settle for a low-paying specialty. Not after all that impossibly hard work and sacrifice, no way. I mean, getting my RN license in 12 months (1000 clinical hours and full-time class) was pretty stressful for me at times, so I'm sure a residency would have been hell on earth for me.
 
Interesting, as long as you are satisfied that is what truly matters. Live life doing what you love!
 
Just to clarify, interns (1st year residents) make 50k +/- 3k.
 
JoBreeze said:
Just to clarify, interns (1st year residents) make 50k +/- 3k.
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If that's the case, then good for them (i was still thinking back to when it was around 40k). But it's still rather meager.

I should clarify what I mean by meager since 50k really isn't that bad of a wage for most folks. But as an intern, that's the wage for 80hr weeks, hellish stress, difficult schedule, etc. I imagine someone who is good with money could bank a little of that away and put it towards debt or something, but for me it would probably go out the door fairly quick due to using it to throw at housing, transportation, last minute tickets out of town when you do end up going due to the difficult intern schedule. Sometimes it's just easier for an intern to throw money at a problem when it arises then it is to try to shop around.
 
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pamac said:
If that's the case, then good for them (i was still thinking back to when it was around 40k). But it's still rather meager.

I should clarify what I mean by meager since 50k really isn't that bad of a wage for most folks. But as an intern, that's the wage for 80hr weeks, hellish stress, difficult schedule, etc. I imagine someone who is good with money could bank a little of that away and put it towards debt or something, but for me it would probably go out the door fairly quick due to using it to throw at housing, transportation, last minute tickets out of town when you do end up going due to the difficult intern schedule. Sometimes it's just easier for an intern to throw money at a problem when it arises then it is to try to shop around.
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As your post implies, the choice to pursue medical school comes down to how badly you want to be a doctor.
 
Interesting posts.

I did just what everyone is saying to do here.

I was an RN, then became a CRNA. Did that for 10 yrs.

Only then did I go to Med School and anesthesia residency.

I wish to Hell, and to everything that is Holy as well, that I had not wasted all that time and done Med Sch right away.

It's only me thinking out loud, but I bet that at least one of the above posters will seriously regret the wasted time and effort of going to PA or Nursing school. A few years down the road, when they decide they are unhappy, only then will they regret giving up their spot in Med School. And if they do go back to Med School, they will still have to do all the work (and it is a lot of work) in order to get where they have always wanted to be.

It may take ten years, but you will be ten years older whether you do Med Sch or not; you would hate to get ten years down the road and regret not doing it. It might be too late by then.

But that's just me.
 
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I dunno. I mean, I've met some docs who say med school wasn't worth it and I've met a lot of PAs and NPs who have been working in their fields for decades and are very happy. I've met unhappy people and happy people in both fields. I think it comes down to the individual, their work environment, their personal ambitions, etc.
 
Dejavu said:
Interesting posts.

I did just what everyone is saying to do here.

I was an RN, then became a CRNA. Did that for 10 yrs.

Only then did I go to Med School and anesthesia residency.

I wish to Hell, and to everything that is Holy as well, that I had not wasted all that time and done Med Sch right away.

It's only me thinking out loud, but I bet that at least one of the above posters will seriously regret the wasted time and effort of going to PA or Nursing school. A few years down the road, when they decide they are unhappy, only then will they regret giving up their spot in Med School. And if they do go back to Med School, they will still have to do all the work (and it is a lot of work) in order to get where they have always wanted to be.

It may take ten years, but you will be ten years older whether you do Med Sch or not; you would hate to get ten years down the road and regret not doing it. It might be too late by then.

But that's just me.
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Yep, just you but I'd be wondering why the heck I wasted all that time in medical school, lol! I mean did your salary and satisfaction level really jump up enough to cover that time and money?
 
zenman said:
Yep, just you but I'd be wondering why the heck I wasted all that time in medical school, lol! I mean did your salary and satisfaction level really jump up enough to cover that time and money?
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See my post.
 
Becoming a physician certainly has its benefits in the long run but really you have to consider if those benefits are worth giving up a decade of your life and a quarter million bucks. Honestly I think about whether it is actually worth it often. I'm not sure. Your 20's are "prime life" where you have your health and there are so many opportunities. My 20's will be gone when I finally finish. I do realize I won't exactly be an old man when I'm done but you still have to ask yourself what that amount of time out of your life is worth.
 
zenman said:
I did and I'm still waiting on Dejavu to give me his answer.
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And your question is a good one. I certainly can't speak for Dejavu's reasoning, but I have been stunned by how many young minds for which it is purely ego. I have now spoken with 3 pre-meds in just 2 months who missed the first cut that have told me MD or bust - they won't even consider DO. Why, I've asked? "prestige" and "title." DO means you have settled.

Similarly, why one would ditch CRNA for "physician anesthesiology" is beyond me. To say, "I'm a doctor" at a cocktail party? Is that worth tens to hundreds of thousands of dollars and 7-10 years of life lost? No one cares what your title is/was when you are on a vent in the ICU at the end of your life. If you are "lucky" you won't be on a vent in the ICU, needing your ET tube suctioned, you will simply be a medical record number in a room number annoying all the nurses with your "knowledge" pushing the call light demanding your diaper be changed and that your finasteride should be given at 2000 instead of 2200.

What people do care about at the end of life is what they should have done with their time on earth. Of course, ego blinds one to both the concept of mortality and the long-term consequences of life choices.

There are posters here who have readily admitted sacrificing family to go from "mid-level" to physician. I guess I just don't get that. You won't be the first MD to die in the ICU alone. I guess you'll have a title and "autonomy," though.
 
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sarjasy said:
Yep, and when you can't cut it with allopathic, go osteopathic -- you're still a doctor, right! (ducking again) :)
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whenever i'm asked a question and I don't know the answer I just tell them i'm only a DO student and the attending usually understands :rolleyes:
 
sarjasy said:
And your question is a good one. I certainly can't speak for Dejavu's reasoning, but I have been stunned by how many young minds for which it is purely ego. I have now spoken with 3 pre-meds in just 2 months who missed the first cut that have told me MD or bust - they won't even consider DO. Why, I've asked? "prestige" and "title." DO means you have settled.

Similarly, why one would ditch CRNA for "physician anesthesiology" is beyond me. To say, "I'm a doctor" at a cocktail party? Is that worth tens to hundreds of thousands of dollars and 7-10 years of life lost? No one cares what your title is/was when you are on a vent in the ICU at the end of your life. If you are "lucky" you won't be on a vent in the ICU, needing your ET tube suctioned, you will simply be a medical record number in a room number annoying all the nurses with your "knowledge" pushing the call light demanding your diaper be changed and that your finasteride should be given at 2000 instead of 2200.

What people do care about at the end of life is what they should have done with their time on earth. Of course, ego blinds one to both the concept of mortality and the long-term consequences of life choices.

There are posters here who have readily admitted sacrificing family to go from "mid-level" to physician. I guess I just don't get that. You won't be the first MD to die in the ICU alone. I guess you'll have a title and "autonomy," though.
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So why be an NP instead then? It is a rhetorical question because I already know the answer.

"Shorter route to make good money".

There is nothing wrong with that, but some of the comments make me chuckle in this thread. I know as an intern I averaged about 50 hours a week and made 54K. Really not that bad. I will be able to moonlight soon and I know of residents clearing low 6 figure salaries. Yes, I can work in an ED, urgent care, and soon moonlight in radiology for a thousand bucks on a Saturday shift. Yes I will make around the average mid-level salary by the end of my second year in residency. Then when I am done I will have 12 weeks vacation and make 5x the midlevel salary and work about 50-55 hours a week.

Going to med school is a good option because you have options.

Being a midlevel is a great option too. I married one so I should know.

Just my 2 cents, just too much misinformation in this thread. Especially the message I quoted because it is implying "no difference between midlevel and physician". This is flat out wrong.
 
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