Frustrated physician assistant student wondering about medical school...

[smallshot]

Hi everyone.

I'm currently a physician assistant student in the 2nd semester of my 1st year. While I had a 3.7 gpa first semester and thoroughly enjoyed it, I find myself cruising along 2nd semester with a lack of motivation and mounting frustration.

I often find myself sitting through class generally uninterested as my professors cruise along presenting various disease states and providing generally little-to-no pathophysiology or explanations whatsoever. I feel like I have to memorize everything because I don't truly understand anything that's going on because my professors don't take the time to explain things. Throughout undergrad, I was never one to memorize everything. I hated it and did it only when I had to. I still attempt to look up as much information as I can, but I feel like this is counterproductive and should've already been explained during class. Now obviously, I get the general idea of these disease states, however im not satisfied with the general idea. I feel i best understand things when I know what's going on at a molecular level.

I thought perhaps it was just me until I talked to a fellow student. Long story short, this student completed 4 years of medical school, ran into difficulty obtaining a residency, and now has found himself stuck in PA school. He agrees with my observations that our professors just shove endless information down our throats and expect us to understand it without truly explaining the information. I ask him questions about med school all the time and the one thing he always tells me is how they explain how EVERYTHING works in med school, instead of just giving you a list of signs/symptoms and treatment and expect you to memorize it like we've been doing for almost 2 semesters now in PA school.

I was a student who contemplated med school for a while, but in the end went the PA route because I entered a 5 year PA masters program as a college freshman and was never 100% sure med school was for me. Also, coming out of high school I didn't think i was really capable of it. Then I excelled in college and it started to cross my mind.

In addition, I worked as a scribe in the ED for 6 months and worked alongside a number of docs and PAs. And having observed both their duties, it dawned on me that I really have no interest whatsoever being stuck doing fast-track/urgent care stuff for the rest of my life (the PAs rarely got any interesting cases). Internal medicine stuff like cardio, nephrology, and GI really interests me.

What I'd like to know is, do you think I'd be better off in med school? Do they really explain everything? Has anyone done both? Is it worth it pursuing med school at this point (I'm 22 y/o)? How did you know it was for you?

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[EuroDoc]

I feel like I have to memorize everything because I don't truly understand anything that's going on because my professors don't take the time to explain things. Throughout undergrad, I was never one to memorize everything. I hated it and did it only when I had to.

Because everyone knows that med school is ONLY deep understanding and hardly no rote memorization... oh wait...

He agrees with my observations that our professors just shove endless information down our throats and expect us to understand it without truly explaining the information. I ask him questions about med school all the time and the one thing he always tells me is how they explain how EVERYTHING works in med school,

Yes, because they do that in MEDICAL school. Do you expect PAs, nurses etc to receive the same level of training as MD's and not get to call themselves just that - MD?

You may bitch about it, but it is really self-evident.

What I'd like to know is, do you think I'd be better off in med school? Do they really explain everything? Has anyone done both? Is it worth it pursuing med school at this point (I'm 22 y/o)? How did you know it was for you?

Can't say if you'll be better off in med school - it's harder, there's a lot of memorization, but I'm sure the personal reward is greater. Of course they don't explain everything, they just explain more than in PA school. I knew medicine was for me b/c: 1) I like the science, 2) I want all doors to be open, 3) I want to be the expert, not the helper, 4) I like interacting with people all day long, 5) I find it personally rewarding to help people.


You have only one life, if you truly want to become a doctor, go for it - instead of regretting not doing it for the rest of your life.

 

[tobi44]

Medical does include a lot of pathophysiology but there is a good amount of rote memorization. Its not always intellectually satisfying at this point, but perhaps it is later in practice.
I wanted to go to medical school because I wanted to treat patients, learn about disease, and get the best training I could find. I liked school and I didn't mind staying in it for several more years then my peers. Never considered any of the mid level routes.

 

[facetguy]

Hi everyone.

I'm currently a physician assistant student in the 2nd semester of my 1st year...blah blah blah.

This doesn't seem that hard.

If money is no object, then stay in PA school while you apply to medical school.

If money is an issue, then drop out of PA school now before you "waste" any more of it, apply to medical school, and put your money where your mouth is.

 

[Slowpoke]

For a second there, I mis-read your post and thought you were a PA in Medical school complaining about how there is so much rote memorization. And I was reading it and agreeing. Then I figure out that you are totally not suggesting this - that medical school is some safe haven to a greater understanding of everything. At this point, (1st year, 2nd semester) I can't say I feel that way.

 

[primadonna22274]

My best advice, as a longtime PA now wrapping up M2, is that you should finish PA school.
It's less likely you will be admitted to med school having dropped out of your PA program than if you finished it and demonstrated ability to complete an arduous training.
Want to understand? Good. Start reading Big Robbins with every system. Read Harrison's or Cecil's after that to solidify your understanding. You don't really need much sleep, right? cut out TV.
I always advise PA students who are on the fence like you are to finish and WORK as a PA for a minimum of a year. You may find you like it and can be a happy and content PA. If not, go back to med school, but let me tell ya it ain't no cakewalk. I'm glad to be doing it but it is expensive, exhausting, and all-consuming. On the other hand, I'm guessing you are about 18 years younger than me and you have lots of time.
Good luck.

 

[D elegans]

Med school is tons of memorization but for things that are conceptual you will be expected to understand them. That doesn't mean they will teach it well but you will at least feel the pressure (and have the resources in terms of books, review books, and other students) to get to that point.

 

[facetguy]

My best advice, as a longtime PA now wrapping up M2, is that you should finish PA school.
It's less likely you will be admitted to med school having dropped out of your PA program than if you finished it and demonstrated ability to complete an arduous training.
Want to understand? Good. Start reading Big Robbins with every system. Read Harrison's or Cecil's after that to solidify your understanding. You don't really need much sleep, right? cut out TV.
I always advise PA students who are on the fence like you are to finish and WORK as a PA for a minimum of a year. You may find you like it and can be a happy and content PA. If not, go back to med school, but let me tell ya it ain't no cakewalk. I'm glad to be doing it but it is expensive, exhausting, and all-consuming. On the other hand, I'm guessing you are about 18 years younger than me and you have lots of time.
Good luck.

Finishing PA school and getting a job as a PA seems like the best option, I agree.

However, with the cost of education today, finishing PA school could cost the OP an additional 50, 75 or even 100K. If s/he can show that academically things were going well, communicate in the personal statement the rationale for leaving PA school early (i.e., wanted to save that boatload of dough for medical school), then reiterate that during interviews, I think med school adcoms could understand that rationale.

On the other hand, if there's any sign of academic difficulties while in PA school, then dropping out will be frowned upon by med schools and you're history.

 

[calvnandhobbs68]

If you can't learn about the pathophysiology of the diseases you're learning about right now by yourself you aren't going to fare well in medical school. Pick up big Robbins and start reading if you're so interested...otherwise you just seem like a whiny PA student who doesn't want to memorize anything.

 

[Lokhtar]

Have fun.

Much cheaper than attending medical school if you just want explanations.

 

[oceanillusion42]

Have fun.

Much cheaper than attending medical school if you just want explanations.

 

[primadonna22274]

^^^Agree

 

[smallshot]

Ok, well let me just clear some things up.

Yes, I know either way there will be tremendous amounts of memorization for various reasons. That's fine, I understand that there will never be a deep understanding of everything and somethings you just have to know. I'm emphasizing that from my experience thus far, PA school is more about memorization first, explanations later. I guess they either hope that you already know it or more so that it's not necessary for our purposes. Unfortunately, for me I didn't expect this. I knew that it wouldn't be nearly half as in depth as medical school, but I guess I expected more. To be honest no matter how much I looked into it and how many people I talked to, I didn't know what to expect until I got into classes and now I'm somewhat disappointed.

And I have always been a proactive student that will go and do extra reading on a topic to gain a better understanding. I guess I just expected to gain more depth and understanding from my professors and classes, which is my fault.

And I don't mean to come off as whiny at all, I'm just saying that my experience in PA school thus far has been more shallow and unfulfilling than anticipated and was wondering if any you guys felt I would appreciate medical school more. Money isn't holding me back. What's holding me back is that I need to take organic II, physics, and biochem lab because they weren't required in my accelerated undergrad curriculum for my 5 year PA masters. And i have to take the MCATs as well.

Obviously, I never stepped foot into a medical school class so I wouldn't know what to expect. I was hoping you guys could clear up what to expect and perhaps how much different it may be from PA school.

And explanations are not my only indications for desiring to go to med school. Like a handful of you said I enjoy the science and learning about disease states, and have learned over time that I desire to be the expert and would like the doors for advancement to be open along with the desire to interact and help people.

As for now, I planned on completing PA school and working for at least a year before I decide if I want to go back or not.

 

[evilbooyaa]

Obviously, I never stepped foot into a medical school class so I wouldn't know what to expect. I was hoping you guys could clear up what to expect and perhaps how much different it may be from PA school.

Focus on advice from former PAs that have since gone to med school for the answer here. I never went to PA school so I can't tell you how different it is. Generally the physiology (1st year) and the pathophysgiology (2nd year) will be the foundation for a lot of other information. There is an awful lot of memorization, but having learned about the pathophys at some point makes re-learning it as a 3rd year student in the clinics significantly easier.

 

[Rothbard]

IME, PA's don't just do urgent care stuff. As a PA you can work in many different fields, in many different settings. There are psych PA's, surgical PA's, etc. You just happened to work in the ED, so you I guess you saw EM PA's. From what I hear, PA's can also switch fields fairly easily, which is a plus for some people. Switching fields in medicine is a usually big deal, and extremely rare after training is complete.

PA's work jobs, doctors have careers. The real question is, are you willing to enter the culture of medicine - do you want to make medicine your life? For about 8 years (the first half, med school, is the easy part), the primary focus of your life will be learning medicine, often at the cost of time with family/friends, sleep, sex, hobbies, exercise, etc. If at some point in your training you get tired, you can't just "take a break" - that becomes a red flag on residency applications. Beyond a certain point you can't leave medicine, because you'll have too much debt.

Med students do learn a lot of pathophys, but our knowledge of pathophysiology is always limited. You can keep asking "why?" indefinitely, and at a certain point the answer is "not sure". In 30 years, are you really going to care that you understand the intricate details of the diseases you are involved in managing? Probably not (but maybe yes). It sounds fun now, but you might have different priorities in 20 years. Lifestyle as a PA is usually much better.

For the vast majority of people (and even for a lot of med students), PA is the better choice. Make sure you know what you're getting yourself into.

If you do go to med school, starting at this age is not a problem. I think the average age of a starting MS1 is 24. There are plenty of people who start in the 25-30 range, even a few who are close to 40.

Obviously, I never stepped foot into a medical school class so I wouldn't know what to expect.

It honestly should not have much to do with your decision, assuming you are academically capable (which you probably are if you have good prereq grades and MCAT scores). You only spend 2 of your 8 years of medical training in a classroom, and those will generally be your easiest years.

Let me just summarize, in case I haven't made this clear: you seem hung up on pathophysiology, but it's only a small part of what medicine is about.

 

[smallshot]

IME, PA's don't just do urgent care stuff. As a PA you can work in many different fields, in many different settings. There are psych PA's, surgical PA's, etc. You just happened to work in the ED, so you I guess you saw EM PA's. From what I hear, PA's can also switch fields fairly easily, which is a plus for some people. Switching fields in medicine is a usually big deal, and extremely rare after training is complete.

PA's work jobs, doctors have careers. The real question is, are you willing to enter the culture of medicine - do you want to make medicine your life? For about 8 years (the first half, med school, is the easy part), the primary focus of your life will be learning medicine, often at the cost of time with family/friends, sleep, sex, hobbies, exercise, etc. If at some point in your training you get tired, you can't just "take a break" - that becomes a red flag on residency applications. Beyond a certain point you can't leave medicine, because you'll have too much debt.

Med students do learn a lot of pathophys, but our knowledge of pathophysiology is always limited. You can keep asking "why?" indefinitely, and at a certain point the answer is "not sure". In 30 years, are you really going to care that you understand the intricate details of the diseases you are involved in managing? Probably not (but maybe yes). It sounds fun now, but you might have different priorities in 20 years. Lifestyle as a PA is usually much better.

For the vast majority of people (and even for a lot of med students), PA is the better choice. Make sure you know what you're getting yourself into.

If you do go to med school, starting at this age is not a problem. I think the average age of a starting MS1 is 24. There are plenty of people who start in the 25-30 range, even a few who are close to 40.



It honestly should not have much to do with your decision, assuming you are academically capable (which you probably are if you have good prereq grades and MCAT scores). You only spend 2 of your 8 years of medical training in a classroom, and those will generally be your easiest years.

Let me just summarize, in case I haven't made this clear: you seem hung up on pathophysiology, but it's only a small part of what medicine is about.

Thank you. You put this into perspective well.

The reason I'm hung up on this is because I want to do my job well, bottom line, no matter if its PA or MD. I feel in order for me to do my job well, for starters, it's imperative to have a fairly deep understanding of disease. I know this isn't possible with every disease, but I'd like to know as much as possible about all the diseases that can be well understood. Enough to help me in practice. This way, when it comes down to diagnosing, managing, treating and patient education I can excel.

At this point, I've just had a stronger desire to know more than most of my classmates who are generally just satisfied with memorizing every detail, but in reality don't really understand it and our professors have begun calling us out on it. I'm just trying to understand as much as I can, and what I can't I will just have to know.

 

[primadonna22274]

I applaud your desire to learn pathophysiology better than it is being taught to you as a PA. I wanted this too and eventually I went back to med school.
Get a Pathoma subscription. Do it with each system and review in your clinical rotations. Read every day-- pick a few patients/conditions that challenged you and study those specifically. I've been doing this since my first clinical rotation as a PA student and it makes a difference.
The sad truth that you must accept is that your professors may not know the deep underlying pathophysiology behind the processes you're learning. If they're PAs, maybe they've never learned them, and if they're physicians, maybe they've forgotten. This is why your learning must be self-directed-- and that's ok.
When I taught PAs I was dismayed that so many of my fellow faculty were PAs who had never worked clinically, or hasn't kept their knowledge and skills current. Don't be one of those PAs. I understand it's tempting to get comfortable and enjoy having a job and a life, but medicine is constantly evolving. If you don't keep up you are worthless.
Good luck to you--I really do admire your fire in the belly