MD or PA?

[Marcy C.]

😕 Are there any medical students out there that were thinking about attending physician assistant school before deciding to go to medical school? Im in that situation right now. Help!

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[analu]

I haven't had any experience re: your question, but there was a very interesting thread started by a PA who got into med school...he talked about his reasons for doing so. You might get what you need from this--http://forums.studentdoctor.net/ubb/ultimatebb.php?ubb=get_topic;f=27;t=000074

Good luck to you!

Edited: sorry, having trouble copying the shortcut...go to Physician Assistant forum, search last 100 days, click on "PA to physician" thread by PACMatthew!

 

[Mango]

I decided to give up my plans for med school and become a PA during my junior year of college. Making that decision made me so happy at the time, because it meant I could avoid so many things that I had ahead of me that were scaring me to death. Things like the MCAT, applying, my low GPA, etc. Plus it meant I could go to Europe for a semester and have the time of my life, since the MCAT was no longer in my future.

So that was my plan, PA school all the way. I even took the GRE, and ordered applications. Then I went on Spring break my senior year of college. One (drunken) night, my friends and I began talking about why I had changed my mind. And I realized that it all boiled down to my fear of not getting into med school. But I also realized that night that if I never tried, I might spend the rest of my life wondering "what could have been."

So I went back to plan A: med school or bust. I graduated in ?98 and got an apartment with friends and a full time PCT job at a hospital. In the back of my mind, I knew that I could use the hands-on patient care experience to fulfill PA school requirements if my med school plans fell through. So I worked, took a Kaplan review class, took the MCAT in ?99, applied to med schools that summer, and was (shockingly)accepted to several. I am now an almost third year med student, and I couldn't be happier with my decision.

Looking back, I wonder what would have happened if I had gone the PA route. I would have probably been very happy, because it still seems like a great job with much more flexibility then the MD gig. But I know I would have second guessed myself, and wondered for the rest of my life if I had made the right decision, which for me, turned out to be med school.

The decision to try for PA school delayed my entering med school by two years, but I am so glad that it did. I am happy that I was able to live in the ?real world? for those two years. I grew up a lot. Plus working in the hospital for 18 months of that time was a huge help. You?d be surprised how many med students have never experienced actual patient care! In any case, I guess my advice boils down to this: chose the path that will make you happiest 20 years from now. Good luck to you.

 

[md03]

At my school, every class has at least one PA or NP who got frustrated with the role and returned to medical school.

I think you need to think about a few things, and top among those is if you would be happy in a PA role. Generally, mid-level providers (as they are also called) have some limitations on autonomy (requiring some form of physician supervision) and may have limitations on prescriptions (may not be able to write for controlled substances).

If you were to watch a PA or NP in action in a family practice office, for example, you would not be able to tell the difference between that person and the physician based on their activites. However, PA and NP dont' get the training to handle more complicated problems.And there are certain things that a midlevel provider will never be able to do....surgery, for example. Though surgeons sometimes employ midlevels (generally work in clinic and may do admission H&Ps and take some in-hospital call to do floor scut), the most acutal surgery you would get to do would be first assist in the OR.

Bascially, the bottom line is this...would you be happy not being the one the buck stops at? If so, you could likely be very happy as PA and can save yourself a lot of time or money. But if you need to be in charge, you'll need to go to med school.

Think long and hard and talk to lots of people in both areas. You can save yourself a lot of frustation that way.

 

[mpp]

I agree. Talk to lots of people in both areas. I think you'll find satisfied and dissatisfied people in both groups. What I found was that what people like about those professions were similar between the two. The dissatisfactions were drastically different.

I was in your shoes once as well. The reason I was thinking PA at all was because of my age and the time commitment involved with medical school. I decided on the medical school route. Let's hope I made the right decision.

 

[rdennisjr]

In general some very good comments - just a small clarification - PA's do perform surgery - lots of 1st assisting, saphenous vein harvesting, neurosurgery,ortho, spinal, etc - while we definetly aren't the leader of the pack, we do get to get our fingers dirty.

Every ones' situation is going to be different of course - I'd love to go to med school and am sure I could do just fine at it. However, being 32 with a wife and a child I thought about it and 7 years minimum before completing the program is just not worth the differnt benifits for me. Your best bet is to do some serious shadowing and interviewing in various areas with both PA and physician (MD/DO) providers and see what it's like for yourself.

Dennis

 

[jlw2004]

I thought about doing PA instead of MD because of the less time and money committment, but while I was shadowing one PA, the supervising MD pulled me aside. He asked me if I could really handle answering to someone else or did I want to be the one making the final decisions. He told me not to settle if being a doctor is what I really wanted. He was right, in my case. You have to look deep inside yourself and decide why you want to do PA vs MD. Like Mango, part of my decision toward PA was fear of not getting into med school and part was not wanting to invest 7+ more years of my life, but I realized for me that I would rather wait and get what I truly wanted than settle for half way and be miserable.

Good luck on your decision. Make the one that is truly best for YOU.

 

[12R34Y]

I agree with the above poster....if you have always wanted to be a doctor then be one. don't settle for being a PA (not that they are bad by any means). My former medical director at my ambulance service is now a physician, but used to be a cardiothoracic surgery PA. He did it because it was fast and cheaper. Ultimately, he was unhappy because he always longed to be the doc. So instead of just sucking it up and going to medschool in the beginning he had to start from scratch and go back. Bottom line......do what you have always wanted to do not what might seem appealing at the time.

later

 

[southerndoc]

I know of someone who graduated from PA school and had to go into the Navy because he couldn't get a job as a PA. He said there is a national "overage" of PA's so it's hard to find jobs.

Maybe one of the PA's could comment on the job prospectus?

Also, Marcy if you're a nurse, why would you go to PA school and not nurse practitioner school? I say go for med!

 

[deleted6669]

in answer to the above poster ther are currently lots of PA jobs to go around. when I graduated from PA school in 1996 the figure was 7 jobs for every new applicant. I had several job offers before even finishing clinicals. with the increase in pa programs over the past 10 years( there are about 120 now) the job market has tightened up a bit, more like 3-5 jobs for every new graduate. I get job offers almost every day in the mail still. there are lots of nurses who end up going the pa route instead of the np route because being a pa allows for more options in the long run and has far more clinical rotation exposure(typical pa program clinical hrs=2200, typical np program 300-600 hrs).np programs are usually specific to a certain field(peds np, psych np, etc) while with a pa degree you can get an entry level job in any field of medicine now. hope that helps-e

 

[southerndoc]

I stand corrected then. Maybe the guy I know joined the Navy for other reasons and just told me it was because of the job market. Who knows.

At any rate, I'm no expert on PA's. 🙂

 

[Bandit]

I knoiw PA`s I went to school with that took nearly 6 months and possibly relocation tio get a job. Others, like myself and nearly all the top students could not get through clinical rotations without getting pounded with offers. This is exactly my point in many threads -- the bad thing is that not all PA`s are created equal. The good ones work when and where they want. The poor ones take H&P`s and give DRE`s all damn day.

 

[KDocGirl]

My sister started PA school and thinks it's probably as rigorous as med school. I have no idea yet since I haven't started classes. But her reasons for doing PA, after long contemplating about applying MD, is that she won't have to go through 2 more years of school and then residency. She likes that PA's have flexibility and lots of responsibilities, yet not total responsibility as a doctor has. The job pays well and EARLY, unlike MDs, who have to go through many years of training to finally begin to see a good paycheck. She wants to do surgery, and it seems like the outlook is great and promising.

On the other hand, my motivations for becoming a doctor are reflective of my personality. I like being in control of a patient's care, which gives more independence and freedom for a practitioner. I love learning and (dare I say it) school. I want to have a wider spread of knowledge to make any diagnosis for a patient. There are many more reasons too.

It just matters how you are and your goals in life. There are many benefits to each profession.
Good luck! Either is a good decision, so don't stress. 🙂

 

[Bandit]

There is an editorial in this months issue of Physician Assistant concerning the "defection" of PA`s to med school. The author claims that the adcoms for PA programs should weed out the potential medical students -- the the profesion is losing some of the best to another profession. I dont know how I feel about this. I dont think I would concentrate on "potential defectors" as much as I would concern myself with aplicants that actuall fit the PA profile. Older, students with broad medical experience and MATURITY. The last this PA programs should do is deny entrance to top flight students though. Hmmm, tough call.

 

[Jeff698]

I was 32 and had been a paramedic for 11 years when I started seriously considering going back to school. At first, it was PA school all the way. Quickly, however, that changed because of two things.

First, I'd never be able to be an EMS medical director which is what I really want to do and second, I'd hate myself if, at 75 and sitting on my porch I asked myself "what if..."

Take care,
Jeff
MS-II
UTMB

 

[Bandit]

Jeff, the new american heart association scientific director in charge of overseeing revisions to the ACLS and PALS protocols is a P.A. named Lyle Larson.

I agree about that "on the porch" thought entirely, but at 37 you really start to wonder if med school would have been too much for the family to take. It is indeed one of the cross`s I must bear for doing other things first.

 

[Jeff698]

Howdy Bandit!

Perhaps I should have been clearer about what I meant by an EMS medical director. There is a statutory requirement in all 50 states that a paramedic must function under the direction of a licensed physician. That's why I said I couldn't do it as a PA.

As for the crosses to bear, you're right. That is very much a personal decision and there is very little that can be extrapolated from one person to the next. I'll be 40 when I finish my residency and my family and I decided it could work. I'm about 10-14 years older than most of my other classmates but I wouldn't give up my EMS career for anything.

Take care,
Jeff

 

[MacGyver]

•••quote:•••Originally posted by KDocGirl:
•My sister started PA school and thinks it's probably as rigorous as med school. I have no idea yet since I haven't started classes. But her reasons for doing PA, after long contemplating about applying MD, is that she won't have to go through 2 more years of school and then residency. She likes that PA's have flexibility and lots of responsibilities, yet not total responsibility as a doctor has. The job pays well and EARLY, unlike MDs, who have to go through many years of training to finally begin to see a good paycheck. She wants to do surgery, and it seems like the outlook is great and promising.

On the other hand, my motivations for becoming a doctor are reflective of my personality. I like being in control of a patient's care, which gives more independence and freedom for a practitioner. I love learning and (dare I say it) school. I want to have a wider spread of knowledge to make any diagnosis for a patient. There are many more reasons too.•••••Why do people constantly feel the need to compare other schools with med school? Cant we just resolve ourselves to the fact that PA school is different than MD/DO school? Besides, how can a 2 year program be just as rigorous as a 4 year program, when the 4 year program covers more material and in a more in-depth fashion?

While PAs can assist in surgery, I've never heard of a PA who got to design the surgical protocol. From what I've seen, PAs who "do surgery" simply follow the explicit directions of the principal surgeon. Its certainly a LOT different from actually being the principal surgeon, in which case you get to decide the specific surgical approach and control all of the finer details that go along with it.

 

[BoonDoc]

Here is a different twist. I applied to several PA schools and didn't get in. There were 6-10 applicants for each slot.
I did a lot of rethinking and am now looking forward to my second year in medical school.

 

[2badr]

•••quote:•••Originally posted by BoonDoc:
•Here is a different twist. I applied to several PA schools and didn't get in. There were 6-10 applicants for each slot.
I did a lot of rethinking and am now looking forward to my second year in medical school.•••••6-10 apps for every slot?! <img border="0" alt="[Wowie]" title="" src="graemlins/wowie.gif" /> Late congrats on your acceptance to med school... 🙂

 

[deleted6669]

That is actally fairly common in terms of applications per spot. many pa programs get &gt;500 applications for 30 spots. it is likely that the previous poster was not accepted because he/she did not have the required medical experience( typically 3-5 years at the level of an rn, paramedic, or resp. therapist) regardless of gpa, etc.
for those of you not familiar with the pa curriculum it is generally 24-27 months in length with the first year composed of didactic classes that are a mix of first and second year md classes( anatomy, pharmacology, physiology, physical diagnosis, history taking, ethics, emergency med lab, clinical lab, etc.). there is less emphasis on topics like histology, embryology, genetics, biochem than in a typical med school program. the second year is equivalent to the third year of medical school with approx 2200 hrs of clinical exposure to basic disciplines like surgery, internal med, pediatrics, ob/gyn, emergency med, psych, and family practice. 2 nd year pa students on rotations are treated as 3rd year med students and have the same call responsibilities as the med students on the service .most programs(mine included) did not differentiate in any way between the md and pa students unless a med student on the service was doing a 4th year sub-I, in which case they were treated like an intern. hope that helps anyone with questions regarding the pa educational process. -e