GP physician vs. PA?

[W19]

I don't know too much about the drawbacks of being a GP physician (1 year internship with no board certification), but I was talking to one the other day and he said the main drawback of being a GP is that you won't be able to have admitting privilege at most (or any) hospital. He said he said he basically work like a FM physician and make over 140k/year working an average 45hrs/wk. I did not ask him about malpractice insurance, how hard it is to find a job etc...

If you have to choose between the two (GP vs PA), what would you choose? I am hoping there are GP physicians who peruse SDN so they can at least share their knowledge of what the GP world is like...

---

Members don't see this ad.

 

[AlexMack12]

I'm not a physician yet, but I'm not completely sure which position you're referring to as a GP- it sounds like there are multiple kinds of positions with the same name!
In my experience with my personal physician and working at a hospital, a general practitioner refers to someone who has either completed a Family Medicine residency OR an Internal Medicine residency (3 years and no subsequent specialization) and are working in primary care. After completion of an IM residency, physicians can practice as GPs in an outpatient setting or as hospitalists in an inpatient setting. From my experience (n=1), outpatient GPs CAN have admitting privileges to hospitals.

I've heard that residents can moonlight provided they've completed at least their intern year in an accredited residency (and so long as it's not against the policy of their program and all that jazz). Those providers aren't considered GPs though to my knowledge and likely have no admitting privileges and the like. However, I'm really not going to do anything more than speculate on this end because I actually don't know for certain.

 

[W19]

@AlexMack12 There are GP physicians out there who did only 1 year residency (or internship)--at least there are some of them in FL... I don't about other states. They have unrestricted license just like IM/FM physicians. These are the type of physicians I was referring to...

 

[AlexMack12]

Maybe it varies by state, since I'm in NY. I hadn't heard of that but thanks for the information! 🙂

My interested was piqued by this (okay, I'm procrastinating studying cardio too...) and found this thread from a couple of years ago:
http://forums.studentdoctor.net/threads/what-can-you-do-after-just-an-intern-year.958909/

Looks like- with everything else, including going to the Caribbean for a degree- it's another case of something that was probably more common in the past and becomes less of a reasonable idea as the years pass.

 

[CherryRedDracul]

You can't become a GP physician anymore as far as I know. Those who did 1 year of internship and then started practicing medicine were grandfathered into Family Medicine. To become a primary care physician, you'll have to do a full-fledged residency (e.g. Family Medicine residency for 3 years).

I can't comment on becoming a PCP vs PA because I don't like outpatient stuff that much. I'm more of an inpatient/OR kind of person.

 

[ACSurgeon]

You can't become a GP physician anymore as far as I know. Those who did 1 year of internship and then started practicing medicine were grandfathered into Family Medicine. To become a primary care physician, you'll have to do a full-fledged residency (e.g. Family Medicine residency for 3 years).

I can't comment on becoming a PCP vs PA because I don't like outpatient stuff that much. I'm more of an inpatient/OR kind of person.

After one year of residency you get an unrestricted license to practice medicine and surgery. Legally you can open any kind of practice you want. You'll run into hospital credentialling issues, getting mal practice insurance might be difficult or impossible, and finally, could be hard to attract patients.

I'm sure there are settings, rural areas etc who will hire a lincensed physician to be a GP or cover the ED/urgent care.

Just like residents can make good money moonlighting, you could work and earn good money without completing a residency in certain areas. I'd never recommend it as plan A, but certainly a viable plan B sometimes

 

[W19]

After one year of residency you get an unrestricted license to practice medicine and surgery. Legally you can open any kind of practice you want. You'll run into hospital credentialling issues, getting mal practice insurance might be difficult or impossible, and finally, could be hard to attract patients.

I'm sure there are settings, rural areas etc who will hire a lincensed physician to be a GP or cover the ED/urgent care.

Just like residents can make good money moonlighting, you could work and earn good money without completing a residency in certain areas. I'd never recommend it as plan A, but certainly a viable plan B sometimes

That physician works outpatient in a midsize city. I should have asked him about insurance panel and malpractice etc... He told me about not being able to get hospital admitting privilege...

 

[PL198]

I think main point is that its very location dependent

 

[Tired]

...

 

[W19]

@Tired What do you mean by saying 'If you are one of the few who fall into the 'prelim medicine/surgery' trap, it is potentially devastating, since your internship will not allow you to become licensed'... Are you saying that you can't get licensed in the states that require 1-year post grad if you do the 1 year of preliminary medicine/surgery?

 

[Tired]

...

 

[DrBodacious]

One of the biggest problems, is that some payors require board certification, or the doctor to be on track for board certification, to be paid. In my area, an ophthalmologist who chose to defer board certification lost the ability to get paid by BCBS, and just had to break down and study for/take boards ten years in to practice.

Maybe primary care isn't affected by this, but I might think they are.

Practically, almost noone chooses to just do one yr post MD.

 

[RustBeltOnc]

I agree with everyone else here.

If you don't know what to do, know that you want to do something primary care medicine-esque, just do conventional, categorical internal medicine (3 years) in a solid place and keep an open mind.

With this credential, you will have no problems getting work, and will have options.

 

[W19]

@RustBeltOnc @DrBodacious I just want to know all possible options since I will get Cs in immunology and neuroscience. Will be ranked in the last quintile of the class for these two classes...

 

[RustBeltOnc]

W19

-- get into medical school. see what you like. you cant go wrong with internal medicine if the more niche fields dont appeal to you.

 

[W19]

W19

-- get into medical school. see what you like. you cant go wrong with internal medicine if the more niche fields dont appeal to you.

I am a MS1 US student ... I am just worried since I am going to get less than 80 in Immunology and Neuroscience. I think that might decrease my chances to get a residency (in psych)... Therefore, I am inquiring about other possible options early on in case I don't match...

 

[RustBeltOnc]

I am a MS1 US student ... I am just worried since I am going to get less than 80 in Immunology and Neuroscience. I think that might decrease my chances to get a residency (in psych)... Therefore, I am inquiring about other possible options early on in case I don't match...

you will be fine. psych is a great field, if you can do c/l rotations, you should do it

 

[TooMuchResearch]

@RustBeltOnc @DrBodacious I just want to know all possible options since I will get Cs in immunology and neuroscience. Will be ranked in the last quintile of the class for these two classes...

Oh.

Don't worry about your preclinical grades so much.

 

[notbobtrustme]

I am a MS1 US student ... I am just worried since I am going to get less than 80 in Immunology and Neuroscience. I think that might decrease my chances to get a residency (in psych)... Therefore, I am inquiring about other possible options early on in case I don't match...

hahahahahhaha what? pre-med neuroticism is leaking again.

the only people that care about pre-clinical grades are you and your mom.

 

[W19]

hahahahahhaha what? pre-med neuroticism is leaking again.

the only people that care about pre-clinical grades are you and your mom.

I don't know, but I think the whole ranking stuff is getting thru me... FWIW, I am two weeks away from finishing with MS1.

 

[styphon]

One of the biggest problems, is that some payors require board certification, or the doctor to be on track for board certification, to be paid. In my area, an ophthalmologist who chose to defer board certification lost the ability to get paid by BCBS, and just had to break down and study for/take boards ten years in to practice.

Maybe primary care isn't affected by this, but I might think they are.

Practically, almost noone chooses to just do one yr post MD.

This will be your stumbling block. I know that NY allows US citizens who attended a US medical school (That means no International/caribbean med grads) to "legally" practice 1 year after residency and finishing your STEP 3.

The problem is the difference between "legally" and "reality". In reality insurance companies, clinics, and malpractice companies do NOT have to accept you and can actually screen you out with the simple statement "BC/BE (board certified/board eligible) physicians only". You can NOT be BC or BE with one year of residency anytime in your future unless you return and finish a residency.

So you will have a problem getting hired, getting paid, and being protected (malpractice insurance). Even urgent cares/prisons are moving towards the BC/BE trend...

 

[zeppelinpage4]

I am a MS1 US student ... I am just worried since I am going to get less than 80 in Immunology and Neuroscience. I think that might decrease my chances to get a residency (in psych)... Therefore, I am inquiring about other possible options early on in case I don't match...

From what I've read on here, psych is one of the relatively less competitive specialties, and pre-clinical grades aren't that important relative to step 1 and clinical grades. So in both regards you should be fine and I wouldn't worry about your performance in MS1. Just make sure you're learning the material properly so you can do your best on step 1 (that will actually help a lot, and leave the most doors open). But no reason to stress at this point, focus on learning. 🙂

 

[redpanda]

I am a MS1 US student ... I am just worried since I am going to get less than 80 in Immunology and Neuroscience. I think that might decrease my chances to get a residency (in psych)... Therefore, I am inquiring about other possible options early on in case I don't match...

Dude, you're in MS1. Worrying about plan D if you don't match right now is ridiculous. Go focus on learning the things you're supposed to be learning. If you really can't stop worrying this far ahead, it might be pathologic.

 

[username456789]

I've been a PA for 7 yrs now after being a nurse for 18 yrs and believe one major advantage to being a Physician Assistants is you always have backup from the supervising physician if needed.

Responsibility when you want it, none when you don't.

 

[ModyzMalak]

One of hosts of a podcast I listen to (medschoolHQ)only did intern year and became a flight surgeon as part of the military. He can no longer practice in the military due to health reasons so he would have to go back and do a full residency. Interesting thought but I think there's too many restrictions after all that work in med school.