md/do vs pa for emergency medicine

[Carrie Bradshaw]

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Hey all, I am a 20 year old slight nontrad interested in emergency medicine. Browsing my local hospitals website I discovered that my local community hospital is full of pa's in the ER. This has made me really interested in that career. I like that its a shorter route to my goal of working in the er, especially since I already feel "old" (ill be a 20 year old freshman) and its decent pay.

My question for current pa's is, is it worth it to pick the shorter route? Did you ever wish that you went all the way and got an md/do? Do you still get to work interesting cases or are you just handed the mundane stuff?

There is a college about thirty minutes from here that offers an associates in PA. Is the job market for a pa with an associates the same or harder than one with a masters? Thanks

 

[benny32311]

Hey all, I am a 20 year old slight nontrad interested in emergency medicine. Browsing my local hospitals website I discovered that my local community hospital is full of pa's in the ER. This has made me really interested in that career. I like that its a shorter route to my goal of working in the er, especially since I already feel "old" (ill be a 20 year old freshman) and its decent pay.

My question for current pa's is, is it worth it to pick the shorter route? Did you ever wish that you went all the way and got an md/do? Do you still get to work interesting cases or are you just handed the mundane stuff?

There is a college about thirty minutes from here that offers an associates in PA. Is the job market for a pa with an associates the same or harder than one with a masters? Thanks

Starting med school at 24 is not old. At all. Some people go back in there 30's, 40's and 50's. It's just two years, and chances are you spent them doing something worthwhile. If you think you want to take the "short way" I would say think again. You are at the prime to be able to accomplish all your undergraduate studies at a bit more of a mature age, which means you will probably be more competitive in your applications for med school. If you think that you would like to be a doctor fully pursue it to the best of your abilities, chances are you won't regret it.

I am not sure about sitting for the PANCE with an associate's degree, but I think you can. There is however, a push to move all PA programs to a graduate level degree.

This is coming from someone in PA school.

If I had to do it all over again, well, I would slap myself when I was 18 and convince myself that I need to take school seriously or just wait a couple of years to go. Do I think that I made poor decision in going to PA school? No. I think it was what I needed to do at my particular point in life. Will I eventually go to MD/DO school? Maybe, it just depends on where my life takes me from this point forward. Hope that helps.

 

[wutthechris]

You won't get into an associate's level PA program with no HCE if that's what you were hoping so it may not be as short of a route as you were thinking.

 

[saywhatsup]

Hey all, I am a 20 year old slight nontrad interested in emergency medicine. Browsing my local hospitals website I discovered that my local community hospital is full of pa's in the ER. This has made me really interested in that career. I like that its a shorter route to my goal of working in the er, especially since I already feel "old" (ill be a 20 year old freshman) and its decent pay.

I have friends tht applied to PA school and didn't get in. Some are working in walmart others, giving it a 2nd attempt. Goodluck. it's tough

 

[BB8730]

Unless you work in a rural ED or there is some other unusual circumstance, ED PA's usually don't see very complex cases. You would see a lot of lacerations, uncomplicated musculoskeletal injuries, and flu-like symptom patients. You wouldn't see anything life-threatening or complicated like intermediate/major trauma, cardiac, abdominal pain, etc. Also, unless you have a lot of experience, you wouldn't see elderly or infant patients either. Some people are perfectly okay with that and love being ED PA's/NP's. Others wish they could do more and regret not going to medical school. The scope is probably location-dependent, but that's my experience from working in an ED and on an ambulance service. I would highly suggest you do some serious shadowing and/or work in an ED before you decide - that's really the only way you can get a flavor for what the differences are between ED mid-levels and ED docs. Good luck!

 

[Makati2008]

Unless you work in a rural ED or there is some other unusual circumstance, ED PA's usually don't see very complex cases. You would see a lot of lacerations, uncomplicated musculoskeletal injuries, and flu-like symptom patients. You wouldn't see anything life-threatening or complicated like intermediate/major trauma, cardiac, abdominal pain, etc. Also, unless you have a lot of experience, you wouldn't see elderly or infant patients either. Some people are perfectly okay with that and love being ED PA's/NP's. Others wish they could do more and regret not going to medical school. The scope is probably location-dependent, but that's my experience from working in an ED and on an ambulance service. I would highly suggest you do some serious shadowing and/or work in an ED before you decide - that's really the only way you can get a flavor for what the differences are between ED mid-levels and ED docs. Good luck!

Smh. Your very misinformed but i will give you a little credit in advising the OP to shadow PAs.

Personally OP at 20yo being a PA should be the last thing on your mind and you should be trying to get into medical school. I speak from personal experience(I am a PA now in medical school and finished PA school in my early twenties. I don't regret going to PA school but with the price of it currently I would advise people to avoid my path)

 

[primadonna22274]

Agree with my buddy Makati.
20, no college yet and no significant health care experience? Work hard, learn well, shoot for med school.
Associates & certificate programs for PAs are going the way of the dinosaur. There is a place for them because they generally are old school-type programs that train those with many years of previous high-level HCE for an advanced practice role as a PA. They are NOT designed for newbies. If you are stuck on PA your best bet might be a direct-entry 5-yr masters PA program (many of these in the Northeast). They are expensive and produce adequate PAs, although my bias is for the stand-alone programs that require a BS and at least 2000hr HCE.
I'm in my 13th yr as a PA and winding down 2nd yr med school in an accelerated 3-yr track. I will graduate at a very young 40. Although I've worked rural EM for half of my career, I have no interest in EM residency--just not my bag. That said, EVERYTHING comes into the rural ED. I have seen and done more than enough trauma for a lifetime. And lastly, the ED is a great place to learn--IF you have patient mentors who are committed to teaching and have the luxury of time to teach--which is IME rare indeed. An inexperienced PA in a busy ED is just dangerous.

 

[BB8730]

Smh. Your very misinformed but i will give you a little credit in advising the OP to shadow PAs.

I worked in an ED for 3 years and that was the scope of our midlevels. I don't know how they operate in other areas around the country, which is why I gave the disclaimer that it's probably location dependent and that my advice is based on my experiences.

Sent from my SCH-I605 using SDN Mobile

 

[primadonna22274]

^^very, very location-dependent.

 

[VictorAlpha]

you're young...shadow and decide.

Try not to think about things like: am i a little old for this or where should I be at this point in my life or what's easiest /shortest or pay / advancement

I mean you can think about these things and I suppose they can be given some short-term consideration. But try to think long-term in how each path fits with your talents and personality and what gives you the most excitement / drive / fulfillment etc.. That is long-term thinking. Some shadowing and talking with PAs and physicians hopefully shed some light on this for you and ultimately guide you toward what will be most personally fulfilling.

 

[AnnoyedByFreud]

I think it's interesting that so many people insist you go to medical school because you're young. I decided to go to NP school at ~24 and I don't regret it one bit. I think a big part of this is to consider your life goals, especially if you're female and want kids. The unfortunate reality is that if you have big plans for a family, you will have to take this into account. People tend to downplay the difficulties of starting a family while in medical school/internship, but at the same time I've seen many threads about how incredibly challenging this is (and even more threads about people complaining about pregnant interns/residents making work harder for everyone else, etc.). I just thought I'd throw in my perspective, since I'm pretty sure most of the people who are telling you to just go for it are male and don't face the same kind of biological pressure, so they might not see it as an issue.

Forbes just published an article about the top jobs for women in 2012 and it found that the average female physician only brings in about ~5k more than the average female NP, annually. It doesn't seem worth it to me to sacrifice my life for the next decade only to bring in a little bit more than I could bring in as a NP. I'm assuming the low pay for female physicians is because most female physicians go into lower paying specialties compared to their male colleagues, and also take off more time. Then again, female NPs also work part-time/take time off to have kids and also go into primary care. I guess it looks like when it comes to primary care (and other lower paying specialties), the difference between female NPs and physicians isn't that great. Now of course there are huge exceptions, but the overall finding was very surprising to me. Just some food for thought. If you're male, then obviously these kinds of concerns are not as pressing.

If you love medicine, go for it. Many people make it work. It wasn't worth it for me, and the Forbes article just reinforced that. Good luck!

http://www.forbes.com/sites/jennagoudreau/2012/07/16/the-20-best-paying-jobs-for-women-in-2012/

 

[Makati2008]

Well one of the posters is female( Ms. Primma) also as a father I can tell you I do as much work as my wife for my child(for example I take off to take my kid to the doc, feed her, change her etc..) so I maybe I am an oddity. Also that will probably decrease during residency and audition rotations.

I do agree though that some specialities are quite anti-pregnany while a resident(surgery) while others seem more open to it(Fm,psych and peds) but all of this would be program specific I would assume.

Lastly, the majority of us base our feeling about this due to having numerous years of clinical practice and once you graduate and work for a while as a MLP you can see where we are coming from. Also is that article based on a Physician working 18hrs/week and the NP working 32 hrs/week to get that discrepancy? I didn't read the article to be upfront.

 

[AnnoyedByFreud]

I believe it's overall salary. Female NPs are just as likely to take time off and to work part-time as MDs/DOs, as far as I can tell. Anyway, I was just trying to add another perspective that I feel many tend to downplay or ignore.

 

[deleted6669]

at 20 you should really aim for medical school. I have worked in EM for 26 years and only over the last 5 yrs of so have I found positions that let me do full scope work(run all cases, do all procedures, etc).
it was a long and painful road working my way up the ladder at jobs that had poor scope of practice and treated PAs like crap. I would work at a place for 2 yrs or so, max out the scope of practice, then take the next "step up" to a better place known for letting PAs do more. none of these better jobs took new grads.
MANY em pa jobs are basically fast track and urgent care. if you want to see anything that comes in the door of an er go md/do. if you are happy doing less pa is fine. I wasn't happy doing less. places where there are fewer docs(inner city, rural, frontier-alaska, etc) are known for better scope of practice.
agree with Makati and Primma above. if my situation was different I would have applied to the first class at lecom with primma. talked to my wife about it seriously but there was no way to swing it with me as primary wage earner, kids in school, mortgage, etc

 

[Makati2008]

at 20 you should really aim for medical school. I have worked in EM for 26 years and only over the last 5 yrs of so have I found positions that let me do full scope work(run all cases, do all procedures, etc).
it was a long and painful road working my way up the ladder at jobs that had poor scope of practice and treated PAs like crap. I would work at a place for 2 yrs or so, max out the scope of practice, then take the next "step up" to a better place known for letting PAs do more. none of these better jobs took new grads.
MANY em pa jobs are basically fast track and urgent care. if you want to see anything that comes in the door of an er go md/do. if you are happy doing less pa is fine. I wasn't happy doing less. places where there are fewer docs(inner city, rural, frontier-alaska, etc) are known for better scope of practice.
agree with Makati and Primma above. if my situation was different I would have applied to the first class at lecom with primma. talked to my wife about it seriously but there was no way to swing it with me as primary wage earner, kids in school, mortgage, etc

Honestly, I can understand and respect that EMED. As far as monies lost I will have to work at one of those EDs in the middle of nowhere and work an ungodly number of shifts to recoup the money I lost the first 2-3years out of residency....

 

[wutthechris]

I have worked in EM for 26 years and only over the last 5 yrs of so have I found positions that let me do full scope work(run all cases, do all procedures, etc).

For fairness of that reply, wasn't the majority of that as an EMT/paramedic? How does that experience differ for EM residency-trained PAs like TA over on the PA forums? Does he see fairly complex cases being only a couple/few years out?

 

[Makati2008]

I have a buddy who did one of those residencies who does so well they schedule him in place of a physician in a moderately busy ED. He does his own central lines,Lps, chest tubes etc

 

[deleted6669]

For fairness of that reply, wasn't the majority of that as an EMT/paramedic? How does that experience differ for EM residency-trained PAs like TA over on the PA forums? Does he see fairly complex cases being only a couple/few years out?

I'm in yr 17 as a PA. a residency makes all the difference as does location (east coast>west coast). had dinner with TA, medic25, and boatswain tonight at sempa in las vegas and they all do a hell of a lot more than I do on a regular basis. a lot of it is about where you work.I have a potential to move my full time job at some point to my current rural per diem job where I can pretty much do anything I want. the downside is that the schools suck and I have young kids.I will take a significant salary and benefits cut to move there(and that's fine) but won't be able to afford a private school for the kids if I do so...after they go to college I think I will likely make the switch.

 

[deleted6669]

Honestly, I can understand and respect that EMED. As far as monies lost I will have to work at one of those EDs in the middle of nowhere and work an ungodly number of shifts to recoup the money I lost the first 2-3years out of residency....

shouldn't be too hard at 200-300/hr...
I did the math for medschool a few years ago. my opportunity cost is well over 1 million dollars(lost wages+ price of school + loans). assuming doubling my salary that has me breaking even around age 62.

 

[deleted6669]

There is a college about thirty minutes from here that offers an associates in PA. Is the job market for a pa with an associates the same or harder than one with a masters? Thanks

associates programs are really designed for folks with YEARS of prior experience at a high level like medic/rn/rt.

 

[J-Rad]

If you love medicine, go for it. Many people make it work. It wasn't worth it for me, and the Forbes article just reinforced that. Good luck!

http://www.forbes.com/sites/jennagoudreau/2012/07/16/the-20-best-paying-jobs-for-women-in-2012/

Why I would look at that Forbes article with a dubious eye:
The inclusion of law as a good career is based on those already in the workforce. No discussion of the bad state of affairs for this overly saturated field.

The listed pay for physicians seems way off. I don't know any physicians making <$100K (this is one listing of average salaries for pediatricians, generally a lower paying field http://www1.salary.com/Physician-Pediatrics-Salary.html). I highly doubt so many female physicians are working such low-hour part time jobs to bring the yearly-salary median down to $79K. The mean salary for female physicians in this study comparing male and female physician salaries was $167 669 http://jama.jamanetwork.com/article.aspx?articleid=1182859.

 

[Carrie Bradshaw]

Thanks for all the responses!
After alot of thinking and searching, i decided to go ahead with my original career path. Re-reading my OP,I see how ridiculous I sounded,saying 20 was too old lol. I know I simply wouldnt be happy with handing off cases to someone else,Id rather see everything that come through the door. Thanks again!