MD vs PA, honest answers from all viewpoints :)

[mountaingirl23]

*repost from a different thread because not sure where it will receive the best attention*

Hey guys! So bear with me, this may be a bit long... but I really would like some honest, thoughtful advice from several different viewpoints.

I am 22, (often confusing it with being about 45), and began college at 17 after graduating high school early. I completed four years at a community college, and just finished a year at a university to complete my undergrad. I am tracking about another year, year and a half to completion. The reason for the four years of community college... trying to figure out what I wanted to do, finished an associates and started pre reqs for nursing, realized I wanted to go into medicine and needed a four year degree, thus, at a university now. I am pursuing a biomedical science degree which is taking slightly longer than other degrees, but I am fine with that. I joined the military at 17 and have been in the Army National Guard for the last 5 years. This is a few days out of the month commitment. I also worked as an EMT for 2 years on an ambulance and have worked the last 6 months as an ED tech in the ED, part time. I also babysit part time and have full time school. I manage this well most days. I work well under stress and prefer it that way.

I have traveled to Africa and Central America within the last year for medical volunteer work which I thoroughly love. This is something I would love to continue to do throughout my life as it brings me so much joy!

I have been in a serious relationship for the last five years (he's 24), and we both have always wanted children and a family. He is also an EMT as well as a firefighter; working on his bachelors as well. Although I know time will tell and you cannot plan everything, we have discussed marriage in the next few years post undergrad, and children after PA school.

Now.... hopefully that is enough background, or maybe too much. But I am back on the PA vs MD debate. I have felt confident in my decision to attend PA school for the past 3 or so years now. However, once starting to work in the ED (fairly busy hospital, close to inner city but still suburbs area, average 200 patients a day with 4 trauma rooms), I have began to question that. All of the PA's that work in our ED are extremely nice and seem to enjoy their career. However, I see most of them doing things such as suturing/ fast track/ low acuity things. All of the big traumas that come in are run by the MD and the trauma surgeon, along with RN's, RT, techs (me 🙂 ), etc. I'm not really sure how I feel about this. I am aware that this is very hospital dependent, but do I really want to be job searching for only specific hospitals in order to practice the way I want to? Also, the idea of a family and traveling is very important to me. Medicine is my passion but I don't want it to consume my life. I'm okay with it being a huge factor but I do crave that balance. The PA school I would like to attend is 3 years, and with med school only being a year longer, is there really any reason not to? I used to think of residency as still being in school and sort of this black hole where you can't do anything else with your life but I'm really seeing that that is not the case. Any insight on residency, or starting a family during it? I am a little worried about when I would be able to have children if I went the MD route. Post med school I will be about 27/28/29 depending on when I get accepted, and I really don't want to wait until after residency to start a family. This is where PA fit perfect as I will have graduated and be able to start my career, have children, buy a house etc....

But I really do worry about the scope. Another issue I had was that I wasn't sure how I felt about specializing. In my head, I would love to dabble in everything, ED, trauma surgery, peds, cardiothoracic, neuro.... but is that just me being young and inexperienced? I have shadowed in all of those departments and am so intrigued by them all. I'm afraid if I specialize I will wish I was able to try other things. This is where PA was a positive as it would allow me to switch within reason. I am okay with extra training for those specialties but unsure of how I feel on going back for a residency each time... I am not sure how heavily I should weight this as my main love is emergency medicine, and maybe with time I will realize that although the other specialties are intriguing, this is the one I want to pursue?

Lastly, I really enjoy research. I have done a few research projects in genetics and micro and would love to continue this throughout my life. I have such a brain for research and am worried about the PA's place in this. I also would love to teach at the med/PA school's while still practicing. I know that PA's are able to do this but is it the same for MD?

I hope this doesn't sound too all over the place. I understand that I am young, but please know that my mindset is not always that of a 22 year old. I have contemplated this for several years, and am not still trying to "soul search". I have lived a much larger life than my 22 years show, and am at the point where I am trying to find the best fit for my future self and family.

EDIT: I have never been interested in primary care. Aside from clinical trials and hard to crack cases, I have never taken much interest to working with the same patients long term. I would rather work with traumas or in the ED where you fix what you can in that time, and either discharge them or send them to a specialist. Don't get me wrong, I do enjoy patient care and talking to patients. I know those statements may be contradictory but if you saw me at work I have extremely good bedside manner. I really do love people. But my heart is in the biology of what's going on over everything else.
I also don't have an ego. I am not searching for that title of Dr. and am comfortable with having people over me. I am very focused on the hands on, though. I really don't want to feel limited in my practice and not able to preform procedures because they are more suited for a doctor. How much autonomy do PA's really have in emergency medicine, from your experience?

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[piii]

Isn't life just great? It's always about sacrifices.

PA: shorter probably cheaper training, more flexibility in switching specialties down the road, shorter time to make a good salary, more freedom for family stuff, but less autonomy.

MD: more autonomy and responsibility, leader of the team, research, more expensive and longer training, less flexibility for life things.

Honestly, you sound like family life is so important to you that going PA is the better route as long as you can swallow your pride and accept that you won't be the medical team leader at most places.

 

[mountaingirl23]

Isn't life just great? It's always about sacrifices.

PA: shorter probably cheaper training, more flexibility in switching specialties down the road, shorter time to make a good salary, more freedom for family stuff, but less autonomy.

MD: more autonomy and responsibility, leader of the team, research, more expensive and longer training, less flexibility for life things.

Honestly, you sound like family life is so important to you that going PA is the better route as long as you can swallow your pride and accept that you won't be the medical team leader at most places.

Thanks for your response! You are spot on about family life being very important to me. However, the one thing I will say is that the debate between PA vs MD for me has never been about pride. I never have felt the need to be the one in charge, or the highest in the chain so to speak. I'm okay with taking on that role, but I am also okay if there is someone in charge of me. The thing for me is, I don't ever want to feel limited in my career. I am okay with not having the title of doctor and having someone think a PA is the equivalent of a medical assistant so long as that I don't feel that I am being held back from the things I want to do. I don't ever want to say "if only I was a doctor I would be able to do that". That is truly my biggest concern.

 

[ArsèneLupin]

Yikes talk about wall of text.

congrats on doing so well up to this point and being engaged. Ill address some of what you are concerned about.

It is possible to have a family with medicine. The catch is you need to be able to balance many things at once and have a good support system. My MIL raised 6 weeks while going to medical school and going through residency so it is possible. During training, you aren't so much in control of your hours so there is the time sacrifice there. However once you are an attending, you can be a little more flexible. I've worked with docs who work 8-11 Mon-Thursday to be able to be a part time mom etc. Im not qualified to address personally about having kids in school or residency but I've seen it be done. PA is right away though a much more family friendly career. Its easier to work 8-5's or 8-3's like some of the PA's ive worked with. PA's may have it easier with lifestyle.

The debate between MD and PA is in the crux of a). Do you want to make the decisions and have the liability? b.)Do you want to have the expertise and knowledge authotity with the sacrifice some of the pan-career flexibility compared to PA? You may not be 1st surgeon as a PA but you'd work as first assist. You may not be the ICU director, but you can certainly work under an ICU doc and see patients. Some docs use the PA's as they used to use residents. Writing notes, rounding, etc. Difference is, the pay, hours, and the ceiling.

Research: Of course you can still do research as a PA. The issue is you're much less likely to be a PI. People that give grants out for research projects like doctorates. You wouldn't be the one running the lab or trial or being head research person. Again this goes back to Do you want to the expertise/knowledge authority point.

Keep being engaged and shadowing and observing the two. The right answer is only known to you. Good luck

 

[mountaingirl23]

Yikes talk about wall of text.

congrats on doing so well up to this point and being engaged. Ill address some of what you are concerned about.

It is possible to have a family with medicine. The catch is you need to be able to balance many things at once and have a good support system. My MIL raised 6 weeks while going to medical school and going through residency so it is possible. During training, you aren't so much in control of your hours so there is the time sacrifice there. However once you are an attending, you can be a little more flexible. I've worked with docs who work 8-11 Mon-Thursday to be able to be a part time mom etc. Im not qualified to address personally about having kids in school or residency but I've seen it be done. PA is right away though a much more family friendly career. Its easier to work 8-5's or 8-3's like some of the PA's ive worked with. PA's may have it easier with lifestyle.

The debate between MD and PA is in the crux of a). Do you want to make the decisions and have the liability? b.)Do you want to have the expertise and knowledge authotity with the sacrifice some of the pan-career flexibility compared to PA? You may not be 1st surgeon as a PA but you'd work as first assist. You may not be the ICU director, but you can certainly work under an ICU doc and see patients. Some docs use the PA's as they used to use residents. Writing notes, rounding, etc. Difference is, the pay, hours, and the ceiling.

Research: Of course you can still do research as a PA. The issue is you're much less likely to be a PI. People that give grants out for research projects like doctorates. You wouldn't be the one running the lab or trial or being head research person. Again this goes back to Do you want to the expertise/knowledge authority point.

Keep being engaged and shadowing and observing the two. The right answer is only known to you. Good luck

Sorry for the long post haha.. Just wanted to cover all my bases. As I mentioned to the other poster above, I am okay with not being the head of decision making. With that being said I do feel very strongly about the hands on portion. I would hate to see the MD's go in on every full trauma that comes in while I sit in fast track suturing.. that's not something I want.
I plan on getting a PhD. Would that help in terms of more authority in research?
Thanks for your advice, very insightful. 🙂

 

[ArsèneLupin]

Sorry for the long post haha.. Just wanted to cover all my bases. As I mentioned to the other poster above, I am okay with not being the head of decision making. With that being said I do feel very strongly about the hands on portion. I would hate to see the MD's go in on every full trauma that comes in while I sit in fast track suturing.. that's not something I want.
I plan on getting a PhD. Would that help in terms of more authority in research?
Thanks for your advice, very insightful. 🙂

Fwiw my ED had trauma PAs with the surgeons and they helped run the traumas. Obviously at an ivory tower large institution this may not be the same.

Afaik there is only one true pa PhD program and that's a 5-6 program. PhD goals are fine but it's more time spent schooling and that seems to distract what your original post has with starting life. At some point you have to end up choosing. I know Md PhDs have labs and do clinical work but again that goes back to balance. Additionally institutions are pushing for more clinical work from their docs. Funding is becoming harder to get from nih etc.

 

[mountaingirl23]

Fwiw my ED had trauma PAs with the surgeons and they helped run the traumas. Obviously at an ivory tower large institution this may not be the same.

Afaik there is only one true pa PhD program and that's a 5-6 program. PhD goals are fine but it's more time spent schooling and that seems to distract what your original post has with starting life. At some point you have to end up choosing. I know Md PhDs have labs and do clinical work but again that goes back to balance. Additionally institutions are pushing for more clinical work from their docs. Funding is becoming harder to get from nih etc.

I think I may look more into that. I knew there were surgical PA's but I am not as familiar with the trauma designation. Unless they are surgical and just work with a trauma surgeon. The PA's that come down with the trauma surgeon at my hospital during full traumas usually don't do too much. But then again the surgeons don't either until they bring them to the OR.
I get that that was kind of contradictory. I am fine being in school for a long time to pursue higher degrees. It's just the type of schooling such as med school, and the rigor of it that has me worried when it comes to life balance.

 

[ArsèneLupin]

I think I may look more into that. I knew there were surgical PA's but I am not as familiar with the trauma designation. Unless they are surgical and just work with a trauma surgeon. The PA's that come down with the trauma surgeon at my hospital during full traumas usually don't do too much. But then again the surgeons don't either until they bring them to the OR.
I get that that was kind of contradictory. I am fine being in school for a long time to pursue higher degrees. It's just the type of schooling such as med school, and the rigor of it that has me worried when it comes to life balance.

The path to having your own lab as a PhD isn't any easier than medical school. Grad school plus sometimes multiple post docs makes it imo a harder course than being a practicing doc.

I can't comment on how easy or hard it is to run a lab with a PhD and PA.

Any school will be rough have be rigorous. However , medical school may not be as scary as you think. The people who are good with time management, have great study skills find the work life balance

 

[cbrons]

How much autonomy do PA's really have in emergency medicine, from your experience?

This has been asked and answered in the Emergency Medicine forums.

In essence, the PAs and NPs are not going to be handling the high acuity stuff.

Based on what I read from your post, I think you should consider med school. You can still apply this season if you get your app together quickly.

Sent from my SM-N910P using SDN mobile

 

[ed*26]

You can get married and start a family in medical school/residency. I personally know two women, one an M3 and one finishing up her intern year in IM, who are pregnant. Another student I know is getting married in a couple months. They make it work, and you can too.

As to MD vs. DO...you are not incorrect that in some hospitals, PAs will be doing lower acuity stuff. Every place will be different, but in all places trauma surgeons will be be doing the higher-level stuff. If that's very important for happiness within your career, then you should become a physician.

 

[JustAPhD]

Based on what I read from your post, I think you should consider med school. You can still apply this season if you get your app together quickly.

She still has a year and a half of undergrad left.

I'm a little confused, as the whole PhD thing came out of left field. When did you plan on doing that? Because you're already worried about being in med school in your late twenties; I'm not sure where you can fit a PhD into that mix. Keep in mind if you don't do a combined program the average length of a PhD is about 5.5 years.

In my opinion you should go for the MD. You can do all the things you want (research and teaching), plus your rotations should give you a much better idea on what you will want to specialize in. It certainly isn't easy starting a family in med school/residency but plenty of people do accomplish it. If you really want that PhD and/or you are a glutton for punishment you could always try MD/PhD programs if your stats are high enough.


I suppose the next logical question is: how are your stats?

 

[OMG I'm going to be an MD]

My first instinct was to recommend picking the MD route; my first words were "I want to be a doctor!!" (I said dada for short). To add my 2 cents, prestige is a mind thing, it's wonderful you're not concerned with that because it's irrelevant to plan your life according to that criterion. Based on your first post, I think you want to be a PA. This route will give you the flexibility you need, not only personally, but career wise. I've met PAs who have a lot of autonomy, but it's very correct to say that MDs have the most autonomy.
On the other hand, you WILL have to SACRIFICE some of your own time if you chose to become an MD, this doesn't mean that you can't have the type of family you described as one. But it does mean that at one point in your career, you will have to place your practice above your family's need (miss recitals, dinners e.t.c). Once my aunt and uncle, both MDs had to work on Thanksgiving. You can minimize these incidences/have more control over your schedule by going into private practice, but then you assume risk/ liability.
My best best advise is to make the best scheme you can of what you want your future career to look like, considering ^^^ and other facts/advises , decide which is best for and be confident enough in that choice to not require input from SDN.
P.S I read you've seen MDs and PAs work, but if you have not already, try shadowing both and gain a better understanding of what it would be like to work as either one.

 

[mountaingirl23]

You can get married and start a family in medical school/residency. I personally know two women, one an M3 and one finishing up her intern year in IM, who are pregnant. Another student I know is getting married in a couple months. They make it work, and you can too.

As to MD vs. DO...you are not incorrect that in some hospitals, PAs will be doing lower acuity stuff. Every place will be different, but in all places trauma surgeons will be be doing the higher-level stuff. If that's very important for happiness within your career, then you should become a physician.

That's good to hear! I am hoping there isn't a stigma that comes with that.. you know, the girl who gets pregnant in med school and drags everyone down with her blah blah.... I don't feel like it has to be like that. That would be my option as I'm not sure I'm willing to sacrifice starting a family until after I start practicing. Thanks for the advice. 🙂

 

[mountaingirl23]

This has been asked and answered in the Emergency Medicine forums.

In essence, the PAs and NPs are not going to be handling the high acuity stuff.

Based on what I read from your post, I think you should consider med school. You can still apply this season if you get your app together quickly.

Sent from my SM-N910P using SDN mobile

Thanks! I really appreciate your reply.

 

[mountaingirl23]

She still has a year and a half of undergrad left.

I'm a little confused, as the whole PhD thing came out of left field. When did you plan on doing that? Because you're already worried about being in med school in your late twenties; I'm not sure where you can fit a PhD into that mix. Keep in mind if you don't do a combined program the average length of a PhD is about 5.5 years.

In my opinion you should go for the MD. You can do all the things you want (research and teaching), plus your rotations should give you a much better idea on what you will want to specialize in. It certainly isn't easy starting a family in med school/residency but plenty of people do accomplish it. If you really want that PhD and/or you are a glutton for punishment you could always try MD/PhD programs if your stats are high enough.


I suppose the next logical question is: how are your stats?

Sorry, the PhD is something I would like to work towards in the future. I don't think it would be a directly after residency thing, maybe after I've practiced for a decade or so. I don't have a problem being in school when I'm older, I just want to be able to start a family while biology still allows me to.. haha. I am fine with returning to school later on if that is still something I want.

Thanks for the help! 🙂

 

[JustAPhD]

Sorry, the PhD is something I would like to work towards in the future. I don't think it would be a directly after residency thing, maybe after I've practiced for a decade or so. I don't have a problem being in school when I'm older, I just want to be able to start a family while biology still allows me to.. haha. I am fine with returning to school later on if that is still something I want.

Thanks for the help! 🙂

Gotcha, just keep in mind you most likely won't be able to practice during those 5 years if you go get your PhD after residency. Just something to keep in mind, best of luck!

 

[mountaingirl23]

My first instinct was to recommend picking the MD route; my first words were "I want to be a doctor!!" (I said dada for short). To add my 2 cents, prestige is a mind thing, it's wonderful you're not concerned with that because it's irrelevant to plan your life according to that criterion. Based on your first post, I think you want to be a PA. This route will give you the flexibility you need, not only personally, but career wise. I've met PAs who have a lot of autonomy, but it's very correct to say that MDs have the most autonomy.
On the other hand, you WILL have to SACRIFICE some of your own time if you chose to become an MD, this doesn't mean that you can't have the type of family you described as one. But it does mean that at one point in your career, you will have to place your practice above your family's need (miss recitals, dinners e.t.c). Once my aunt and uncle, both MDs had to work on Thanksgiving. You can minimize these incidences/have more control over your schedule by going into private practice, but then you assume risk/ liability.
My best best advise is to make the best scheme you can of what you want your future career to look like, considering ^^^ and other facts/advises , decide which is best for and be confident enough in that choice to not require input from SDN.
P.S I read you've seen MDs and PAs work, but if you have not already, try shadowing both and gain a better understanding of what it would be like to work as either one.

Thanks for the advice! I agree with you on all points. I will do some more shadowing and interviewing of these providers to get some more personal insight. I am okay with sacrifice. I'm already used to working most holidays as an EMT (although I know it is very different once you have children) and my boyfriend is a firefighter. So, I think regardless of which one I choose it is almost guaranteed that some holidays are going to be missed between the two of us. The only thing I am not willing to sacrifice is starting a family. I don't want to wait until I'm in my mid thirties before trying, although there is nothing wrong with that, it's just not for me. My parents had me late (38 and 40) and seeing how they are quickly aging while I'm at the age I am it's not something I want to repeat if I don't have to.

 

[mountaingirl23]

Gotcha, just keep in mind you most likely won't be able to practice during those 5 years if you go get your PhD after residency. Just something to keep in mind, best of luck!

Good thought, I didn't think of that.
Thanks again!

 

[Efflorescence]

The only thing I am not willing to sacrifice is starting a family. I don't want to wait until I'm in my mid thirties before trying, although there is nothing wrong with that, it's just not for me.

I have a family member who is a 28 year-old single female PA. I suspect she chose the PA route over MD because of the flexibility and shorter training. However, it's entirely possible she won't have kids before her mid-thirties because she simply hasn't met the right guy yet. She chose the more "family-friendly" route, but she could not plan her entire future.

Also, I understand that you and your boyfriend are serious and have discussed marriage. This is a hard question to ask yourself: If, by chance, your relationship ended and you found yourself single and in PA school, would you wish you were in medical school?

I'm only addressing one small part of your question, but I hope it's food for thought. Full disclosure ... I'm a 22 y/o single incoming female MS1 who considered the PA route at the beginning of college because I also want a family.

 

[ProspectiveKidd]

For me it has simply come down to the desire to advocate for my patients from the highest possible standpoint, and making the sacrifices that come with that responsibility and privilege. I'm headed into my late 20s and I won't start med school till around 30.

To be fair I don't have kids or a long term relationship like you do. If those are things you decide you are dedicated to more than medicine (which is totally fine) then you might want to reconsider MD. My younger sister wanted to go MD but wants the time in her life for her family, and it looks like she's considering other options as a result. Conversely, you have expressed concern with the scope of practice which will possibly cause some dissonance with job fulfillment.

 

[ed*26]

If you're interested, The Premed Years is a decent podcast about medical school admissions and they recently interviewed someone who had worked for several years as a PA (primarily in ED, I believe) and is now in medical school. He had very positive things to say about both career paths and concrete reasons to switch to MD, so you may find it informative. It's episode #170, found here.

 

[DetectiveAlonzo]

Get that MD.

MD = Mo' Dolla$$$$$

 

[LizzyM]

Graduate school, particularly in the sciences, is a young person's "game" (I use that word but don't mean it isn't a serious thing). The idea is to train you in your 20s, let you do science in your 30s and then in your 40s and beyond you provide the support (funding dollars and mentoring) to bring along the next generation of young scientists. While you are in a grad program you are the "employee" of the person whose lab you are in. The official title is "student" or "trainee" but the idea is that you are working in their lab as much as humanly possible because the success of the lab depends on moving the ball forward. Without research success there is no more funding and without more funding the lab withers and dies.

I can't see someone going to a PhD program in the sciences after age 30.

Furthermore, if you were to go into the legalized slavery of a PhD program while you are an MD, your clinical skills would wither while you worked on the doctoral degree. People who do both have strong research skills developed in college and do a 7 year program that includes 2 years of med school pre-clinical education with some lab time on the side, 3-4 years of doctoral study and research and 1-2 years of clinical clerkships and electives in clinical settings. The plus of these programs is that they include tuition and stipend but one never breaks even given the opportunity cost of delaying one's entry into practice. On the other hand, having little debt means being more flexible in taking an academic job that may pay less than some private practice clinical positions.

@mountaingirl23 you seem like too much of an adrenaline junkie to want the slow pace of a lab (the days may go quickly but the science proceeds very slowly).

 

[jtd2081]

There is a large amount of responses here, so I am sorry if I missed this. Why do you want a PhD? Is there a particular reason you want to spend the time to get an MD only to go back to school to get a PhD on top of that?

 

[Yadster101]

Disclaimer: If it's not clear from my post below, you MUST have a genuine interest in medicine/working with pts to do either MD/DO or PA/NP.

As someone that spent two years after college deciding between PA vs med, let me give you my advice. I initially wanted to go to PA school because it would allow me to work in medicine, both professional and personal flexibility, and a great salary with minimal debt/time training. I've shadowed in ERs where the doc and PA simply split pts, I've seen family med PAs with their own pt panel, I've seen surgery PAs first assist and evaluate pts individually. PAs are in great demand and if you want to do intubations, chest tubes, central lines, etc. then you can as long as you're a bit flexible with location (i.e might not get to work at the exact hospital you want). Being a PA also makes a lot of financial sense. The PA school I wanted to go to had a COA of ~$90k for 2 years while med school is ~$300k for 4 years. EM PAs start at ~100k (50/hr) and can easily work up to $130-150k after a few of years. The opportunity cost for med school is VERY high and if you take out interest based loans and go into FM its possible that you wont be financially equivalent to the PA till your 50's. FM docs in my area start at ~150k which isn't that much higher than an experienced EM PA working 3 12's.

Despite all this I picked med school for the reasons below:
1) PA school is NOT easy. At many PA schools the students share classes with the med students. At UIowa the PA/Med students are indistinguishable for MS1/MS2 (same exams, lectures, professors, etc.). The PA students that I've seen during their clinical rotation are also putting in the same # of hours as the med students, but they only do 1 year of clinicals.
2) Many PAs go onto get additional education (MS, MA, PhD) because they feel something is lacking.
3) MD/DO lifestyle in FM is VERY similar to PA FM lifestyle. The doctors end up making $60k+ for the same hours (which is obviously justified due to the > training)

The reason I chose to go to med school is because the #'s worked out for my particular situation in terms of debt and salary expectations. By about age 40 (8 years into practice) I'll be financially equivalent to an EM PA that started working at age 26. Ppl on these forums will tell you to not worry about the money but that is BS. If you're a primary care doc with 400k+ in debt doing a 20 year repayment, then that is not a good financial situation.

Obviously docs also have opportunities that no PA does (optho, any surgery, PMR, anesthesia, etc.) In the end you gotta make a decision based on your personal circumstances and your professional/personal goals.

 

[mountaingirl23]

I have a family member who is a 28 year-old single female PA. I suspect she chose the PA route over MD because of the flexibility and shorter training. However, it's entirely possible she won't have kids before her mid-thirties because she simply hasn't met the right guy yet. She chose the more "family-friendly" route, but she could not plan her entire future.

Also, I understand that you and your boyfriend are serious and have discussed marriage. This is a hard question to ask yourself: If, by chance, your relationship ended and you found yourself single and in PA school, would you wish you were in medical school?

I'm only addressing one small part of your question, but I hope it's food for thought. Full disclosure ... I'm a 22 y/o single incoming female MS1 who considered the PA route at the beginning of college because I also want a family.

That's a really good way of looking at it that I had only briefly considered. If I was single right now then yes, there would be no doubt I would go to medical school. Thanks for that! Kind of puts things into perspective. Good luck in med school! 🙂

 

[mountaingirl23]

For me it has simply come down to the desire to advocate for my patients from the highest possible standpoint, and making the sacrifices that come with that responsibility and privilege. I'm headed into my late 20s and I won't start med school till around 30.

To be fair I don't have kids or a long term relationship like you do. If those are things you decide you are dedicated to more than medicine (which is totally fine) then you might want to reconsider MD. My younger sister wanted to go MD but wants the time in her life for her family, and it looks like she's considering other options as a result. Conversely, you have expressed concern with the scope of practice which will possibly cause some dissonance with job fulfillment.

I guess I hadn't considered that I shouldn't rule out family with med school. Knowing that it could be a possibility makes the decision a little easier. I wouldn't say I am dedicated to family more than medicine, but they are on very similar playing fields and I would like to be able to balance the two. You're correct in that I am worried about a potential career ceiling and I don't want to feel limited in my practice. Thanks for the input!

 

[mountaingirl23]

If you're interested, The Premed Years is a decent podcast about medical school admissions and they recently interviewed someone who had worked for several years as a PA (primarily in ED, I believe) and is now in medical school. He had very positive things to say about both career paths and concrete reasons to switch to MD, so you may find it informative. It's episode #170, found here.

Thank you! That was really informative!

 

[mountaingirl23]

Get that MD.

MD = Mo' Dolla$$$$$

Hahahaha

 

[mountaingirl23]

Graduate school, particularly in the sciences, is a young person's "game" (I use that word but don't mean it isn't a serious thing). The idea is to train you in your 20s, let you do science in your 30s and then in your 40s and beyond you provide the support (funding dollars and mentoring) to bring along the next generation of young scientists. While you are in a grad program you are the "employee" of the person whose lab you are in. The official title is "student" or "trainee" but the idea is that you are working in their lab as much as humanly possible because the success of the lab depends on moving the ball forward. Without research success there is no more funding and without more funding the lab withers and dies.

I can't see someone going to a PhD program in the sciences after age 30.

Furthermore, if you were to go into the legalized slavery of a PhD program while you are an MD, your clinical skills would wither while you worked on the doctoral degree. People who do both have strong research skills developed in college and do a 7 year program that includes 2 years of med school pre-clinical education with some lab time on the side, 3-4 years of doctoral study and research and 1-2 years of clinical clerkships and electives in clinical settings. The plus of these programs is that they include tuition and stipend but one never breaks even given the opportunity cost of delaying one's entry into practice. On the other hand, having little debt means being more flexible in taking an academic job that may pay less than some private practice clinical positions.

@mountaingirl23 you seem like too much of an adrenaline junkie to want the slow pace of a lab (the days may go quickly but the science proceeds very slowly).

This is good food for thought. Thank you, as I wasn't really aware of this. I have family that received their PhD's in their 40's and 50's, however, they were not in medicine. I do like the fast passed environment that the ED yields, however, I do enjoy working with clinical trials and developing new things in the lab. This isn't something that I would want to do full time, but in conjunction which being a practicing MD. Do you think the PhD would be less worth it if I wasn't planning on dedicating the majority of my time in the lab? Also, do MD's do much research without a PhD or not so much? Thanks for your help.

 

[mountaingirl23]

There is a large amount of responses here, so I am sorry if I missed this. Why do you want a PhD? Is there a particular reason you want to spend the time to get an MD only to go back to school to get a PhD on top of that?

Hey! That's okay! I guess I linked the PhD with being able to do research, run clinical trials, etc.. which is something I really enjoy. I would like to be able to be involved in research throughout my career, but do you know if I'd be able to do that without the PhD? I also would like to be able to teach at the medical schools, so I figured the PhD would help with that.

Also I just really love school haha.

 

[mountaingirl23]

Disclaimer: If it's not clear from my post below, you MUST have a genuine interest in medicine/working with pts to do either MD/DO or PA/NP.

As someone that spent two years after college deciding between PA vs med, let me give you my advice. I initially wanted to go to PA school because it would allow me to work in medicine, both professional and personal flexibility, and a great salary with minimal debt/time training. I've shadowed in ERs where the doc and PA simply split pts, I've seen family med PAs with their own pt panel, I've seen surgery PAs first assist and evaluate pts individually. PAs are in great demand and if you want to do intubations, chest tubes, central lines, etc. then you can as long as you're a bit flexible with location (i.e might not get to work at the exact hospital you want). Being a PA also makes a lot of financial sense. The PA school I wanted to go to had a COA of ~$90k for 2 years while med school is ~$300k for 4 years. EM PAs start at ~100k (50/hr) and can easily work up to $130-150k after a few of years. The opportunity cost for med school is VERY high and if you take out interest based loans and go into FM its possible that you wont be financially equivalent to the PA till your 50's. FM docs in my area start at ~150k which isn't that much higher than an experienced EM PA working 3 12's.

Despite all this I picked med school for the reasons below:
1) PA school is NOT easy. At many PA schools the students share classes with the med students. At UIowa the PA/Med students are indistinguishable for MS1/MS2 (same exams, lectures, professors, etc.). The PA students that I've seen during their clinical rotation are also putting in the same # of hours as the med students, but they only do 1 year of clinicals.
2) Many PAs go onto get additional education (MS, MA, PhD) because they feel something is lacking.
3) MD/DO lifestyle in FM is VERY similar to PA FM lifestyle. The doctors end up making $60k+ for the same hours (which is obviously justified due to the > training)

The reason I chose to go to med school is because the #'s worked out for my particular situation in terms of debt and salary expectations. By about age 40 (8 years into practice) I'll be financially equivalent to an EM PA that started working at age 26. Ppl on these forums will tell you to not worry about the money but that is BS. If you're a primary care doc with 400k+ in debt doing a 20 year repayment, then that is not a good financial situation.

Obviously docs also have opportunities that no PA does (optho, any surgery, PMR, anesthesia, etc.) In the end you gotta make a decision based on your personal circumstances and your professional/personal goals.

Yes, and sorry if I didn't portray that very well. I do have an genuine interest in patient care, or I wouldn't be doing what I do now!

Thanks for the advice. I do have a question though... I keep seeing the number 400K+ for medical school debt being thrown out there.. Now, I'm sure I'm just not thoroughly educated on this, but where does that number come from? Most medical schools I have seen are around 20-60K a year and that does not add up to anywhere near 400K. Are there additional costs included in residency? I'm sorry if this is naive, I'm just unsure. 🙂

 

[ArsèneLupin]

Hey! That's okay! I guess I linked the PhD with being able to do research, run clinical trials, etc.. which is something I really enjoy. I would like to be able to be involved in research throughout my career, but do you know if I'd be able to do that without the PhD? I also would like to be able to teach at the medical schools, so I figured the PhD would help with that.

Also I just really love school haha.

MDs run clinical trails. Some MDs run labs or research projects. Some MDs hire out research PhDs and assistants for their labs. PhD isn't absolutely needed for a MD to research. If you want to be a mid level and do/run basic science and clinical trials/ research that may not be as feasible

 

[mountaingirl23]

MDs run clinical trails. Some MDs run labs or research projects. Some MDs hire out research PhDs and assistants for their labs. PhD isn't absolutely needed for a MD to research. If you want to be a mid level and do/run basic science and clinical trials/ research that may not be as feasible

Good to know, thank you!

 

[MediocreGunner]

Yes, and sorry if I didn't portray that very well. I do have an genuine interest in patient care, or I wouldn't be doing what I do now!

Thanks for the advice. I do have a question though... I keep seeing the number 400K+ for medical school debt being thrown out there.. Now, I'm sure I'm just not thoroughly educated on this, but where does that number come from? Most medical schools I have seen are around 20-60K a year and that does not add up to anywhere near 400K. Are there additional costs included in residency? I'm sorry if this is naive, I'm just unsure. 🙂

That's just tuition. You forgot cost of living (like food, housing, transportation), study materials (books), tests (STEP), residency interviewing costs ,and interest (which accrues during medical school, residency, forever until you pay your loans back). I'm sure I forgot other things. But medical school is really expensive.

 

[mountaingirl23]

That's just tuition. You forgot cost of living (like food, housing, transportation), study materials (books), tests (STEP), residency interviewing costs ,and interest (which accrues during medical school, residency, forever until you pay your loans back). I'm sure I forgot other things. But medical school is really expensive.

Ok, thanks. I figured the rest of it was those other expenses. I didn't forget about them, I just factor them in differently in my head. I don't like to group them all together and say that it's all tuition. Just my preference. Thanks for clearing that up!