MD vs. PA, What is the best option?

[peudamour]

Hello All! Thank you for taking the time to read this post.

I have been very impressed by the wealth of knowledge on these forums!

I am a current college student. I have gained a renewed interest in healthcare as a primary care provider (in varying capacities...) and am very interested in going to PA school.

My plan, as of now, is to:
1. Finish my degree in the next two semesters, if possible.
2. Go back to school immediately to work on my prereqs for PA school (four semesters) while at the same time...
3. ...becoming certified as an EMT (two semesters) and then working as an EMT for 2000 hours (one year)
4. Apply to and get into PA School; work hard and finish

Overall this plan should take about 5 years.

But at the same time, I am wondering if after doing all this work to go to PA school, I would regret not trying for an MD.

I would just like opinions from people that know these fields or have experience with this dilemma. Also any advice on working towards PA school would be appreciated.

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[deleted6669]

GO TO MED SCHOOL (MD OR DO).
if you are in a position to decide, go to med school or you will spend years wishing you had.
PA school is really for experienced clinicians(paramedics, nurses, resp. therapists, etc) wishing to take a next step up the ladder, not recent college grads starting a first career. if I could do it over, I would go to DO school without a doubt. the lack of respect and arbitrary restrictions put on you as a pa are just not acceptable or worth the return on investment of time and money.

 

[peudamour]

Thank you, emedpa. Do you think it would still be worth it for me to try out working as an EMT to gauge my compatibility with healthcare?

 

[deleted6669]

yes, many programs like to see some prior exposure to healthcare and/or research.

 

[Makati2008]

Thank you, emedpa. Do you think it would still be worth it for me to try out working as an EMT to gauge my compatibility with healthcare?

Agree with EMEDPA. I am a PA that went back to DO school(just graduated so I guess I'm Dr. PA lol). If you have questions inbox me.

 

[peudamour]

Alright, thanks guys!

Would it make that big of a difference to MD schools if I didn't do a Biology centered major and/or didn't take my prereqs as part of my Bachelor's degree?

 

[Makati2008]

Alright, thanks guys!

Would it make that big of a difference to MD schools if I didn't do a Biology centered major and/or didn't take my prereqs as part of my Bachelor's degree?

Nope. Just make sure they are university affiliated. Community college courses can sometimes be an issue

 

[princekc]

I agreed with M & E.

 

[AlbinoHawk DO]

OP, I would recommend you go out there and shadow people. Go see which job you prefer. I understand that some PAs here are very vocal about disliking their profession, but you'll see that doctors that will tell you to run while you still can and find another profession are also dime a dozen. Don't go just by some internet poll. This is your life. Invest the time talking to many people and shadowing professionals. For all you know you may not want to be a doctor nor a PA. Maybe you'll fall in love with Optometry or something completely outside healthcare. Right now is the only time you have to make this huge decision, which will affect your entire life.

 

[peudamour]

.

 

[didymus]

OP, I would recommend you go out there and shadow people. Go see which job you prefer.

This.

Also, I was encouraged by current practicing physicians to go to PA school. I think what one finds as he or she talks to more and more people is that the grass is always greener on the other side. I think it is important for you to ask yourself what you want out of life and out of your career. @emedpa talks often about the lack of respect from patients and physicians for PA's, and the professionally-encumbering restrictions put on them, but this is not a serious issue for all people. Myself? I took my AMCAS profile from my medical school application and switched it over to CASPA, and just submitted my application to PA school.

For me, I wanted a small school-debt load, a short training program, freedom to work in a variety of specialties throughout my career, less overall clinical responsibilities, and the option to serve medically overseas--all while retaining a decent level of autonomy and clinical collaboration. I'm also 30, with a wife who is a full-time physician, and a young child at home. 4 years of medical school, plus a minimum 3 year residency, and the potential for >$250K in educational debt, decreasing reimbursements, and increasing regulations on physicians steered me in a different direction. Therefore, YMMV. So, again, shadow, ask questions, take the answers with a grain of salt--but use them to build a treasury of perspective--then do some soul searching and make a decision.

 

[peudamour]

This.

Also, I was encouraged by current practicing physicians to go to PA school. I think what one finds as he or she talks to more and more people is that the grass is always greener on the other side. I think it is important for you to ask yourself what you want out of life and out of your career. @emedpa talks often about the lack of respect from patients and physicians for PA's, and the professionally-encumbering restrictions put on them, but this is not a serious issue for all people. Myself? I took my AMCAS profile from my medical school application and switched it over to CASPA, and just submitted my application to PA school.

For me, I wanted a small school-debt load, a short training program, freedom to work in a variety of specialties throughout my career, less overall clinical responsibilities, and the option to serve medically overseas--all while retaining a decent level of autonomy and clinical collaboration. I'm also 30, with a wife who is a full-time physician, and a young child at home. 4 years of medical school, plus a minimum 3 year residency, and the potential for >$250K in educational debt, decreasing reimbursements, and increasing regulations on physicians steered me in a different direction. Therefore, YMMV. So, again, shadow, ask questions, take the answers with a grain of salt--but use them to build a treasury of perspective--then do some soul searching and make a decision.

Thanks didymus!

 

[didymus]

Thanks didymus!

You are quite welcome! All the best to you as you explore your options and make some decisions.

 

[Dentalguy8621]

Thanks didymus!

I was in the same position this past year. I didn't want to take the step to do MD/DO for a variety of reasons. I ended up now pursuing dentistry but that's besides the point. I would pick PA over MD anyday. I cherish my time away from work and being a physician would have been a very difficult life for me. Get in the hospital and really immerse yourself in the environment. I got a quick CNA certification and have worked in cardiac for a bit now. I would never want the life of a physician and most PAs that I shadowed/spoke to are very happy people who love their work. They didn't want to be the ultimate decision maker, liked collaboration, wanted less restrictions and less liability and the ability to pick the speciality they wanted. Most doctors (anesthesiologists, internal medicine, peds) told me to stay far away and their basis on this advice centered around what people didymus stated above. Like others stated, figure out what's best for you. That's what's important. Both are excellent in their own ways and having the opportunity to decide between both is a blessing in itself. Cheers.

 

[didymus]

I was in the same position this past year. I didn't want to take the step to do MD/DO for a variety of reasons. I ended up now pursuing dentistry but that's besides the point. I would pick PA over MD anyday. I cherish my time away from work and being a physician would have been a very difficult life for me. Get in the hospital and really immerse yourself in the environment. I got a quick CNA certification and have worked in cardiac for a bit now. I would never want the life of a physician and most PAs that I shadowed/spoke to are very happy people who love their work. They didn't want to be the ultimate decision maker, liked collaboration, wanted less restrictions and less liability and the ability to pick the speciality they wanted. Most doctors (anesthesiologists, internal medicine, peds) told me to stay far away and their basis on this advice centered around what people didymus stated above. Like others stated, figure out what's best for you. That's what's important. Both are excellent in their own ways and having the opportunity to decide between both is a blessing in itself. Cheers.

Very well said! Something that has helped me in my decision is the fact that I have not ever personally met a PA experiencing burn out. Conversely, most every physician I know is burnt out. That speaks volumes to me.

 

[paolakit]

GO TO MED SCHOOL (MD OR DO).
if you are in a position to decide, go to med school or you will spend years wishing you had.
PA school is really for experienced clinicians(paramedics, nurses, resp. therapists, etc) wishing to take a next step up the ladder, not recent college grads starting a first career. if I could do it over, I would go to DO school without a doubt. the lack of respect and arbitrary restrictions put on you as a pa are just not acceptable or worth the return on investment of time and money.

Hello, can you expand on PAs lacking respect? Have you observed that first hand? Just curious, considering most PAs report high job-satisfaction and respect from supervising physician and team they work with. I have been reading a lot on PAs so I would like to know if lack of respect is just something PAs are not disclosing. Also, I understand the restrictions, but how do you determine a PA program is not worth the time/money investment? Is this relative to physicians? Thanks!

 

[pamac]

Most PA schools are close to $100k. (Multiply that by two more years and you are looking at $200k, which is in medical school territory.... Without physician style salary).

PAs I see have about the same hours as physicians, but instead of raking in major profits from their practice like the physicians, they are rather well paid employees. So the docs sit on $400k+ wages and tax breaks, and PAs draw $100k and maybe a bonus if they are productive. Some people see the wage issue as a demonstration of how much respect you are getting, but I'm not sure that's a respect issue, but an issue of who went to more school and who carries more expertise.

Ive seen plenty of physician only lounges, and by that they mean physicians only.

Then there are staff. My facility isn't full of jerk nurses who would treat a PA badly. But the economics of time dictate that a physician walking in gets more of my kid gloves than any other provider, if only because they are the business owners that the facility depends on to drive work our way, and sign the contracts. PAs don't operate in that role. It's just a matter of recognizing who the boss is. Maybe some folks pick up on that and it chafes a bit. As far as patient care goes, an order is an order, and I usually see whoever is writing them as an asset, no matter what their pay rate is. If a PA is writing for a HAB when I need it for a patient, they are as useful to me as a physician.

 

[Makati2008]

Hello, can you expand on PAs lacking respect? Have you observed that first hand? Just curious, considering most PAs report high job-satisfaction and respect from supervising physician and team they work with. I have been reading a lot on PAs so I would like to know if lack of respect is just something PAs are not disclosing. Also, I understand the restrictions, but how do you determine a PA program is not worth the time/money investment? Is this relative to physicians? Thanks!

It's practice dependent. If you work in a rural clinic people will be gratefu to have you the flip side is working in a rural er trying to transfer a patient then the disrespect can be pretty blatant.

Also bigger hospitals can be somewhat of a hierarchal system where midlevels are doing scut while attending/residents getting the cool stuff. Also like Pamac said, some places won't even let you eat in the lounge with docs. At my second job, we were allowed to eat with docs(for free) and shower there if needed, well during my time there they deactivated our badges where we could not use that part of the hospital.

A nice slap in the face , we were good enough to see your patients and make you money but can't eat in a lounge with our attending or alone. Also to me it was further irritating that the docs wouldn't go to bat for the midlevels and some even verbally agreed saying there are some things we might not want you to hear and sometimes it's good to have some things physician only to promote a collegial atmosphere with our peers....

 

[Dentalguy8621]

Most PA schools are close to $100k. (Multiply that by two more years and you are looking at $200k, which is in medical school territory.... Without physician style salary).

PAs I see have about the same hours as physicians, but instead of raking in major profits from their practice like the physicians, they are rather well paid employees. So the docs sit on $400k+ wages and tax breaks, and PAs draw $100k and maybe a bonus if they are productive. Some people see the wage issue as a demonstration of how much respect you are getting, but I'm not sure that's a respect issue, but an issue of who went to more school and who carries more expertise.

Ive seen plenty of physician only lounges, and by that they mean physicians only.

Then there are staff. My facility isn't full of jerk nurses who would treat a PA badly. But the economics of time dictate that a physician walking in gets more of my kid gloves than any other provider, if only because they are the business owners that the facility depends on to drive work our way, and sign the contracts. PAs don't operate in that role. It's just a matter of recognizing who the boss is. Maybe some folks pick up on that and it chafes a bit. As far as patient care goes, an order is an order, and I usually see whoever is writing them as an asset, no matter what their pay rate is. If a PA is writing for a HAB when I need it for a patient, they are as useful to me as a physician.

Most PA schools are close to $100k. (Multiply that by two more years and you are looking at $200k, which is in medical school territory.... Without physician style salary).

PAs I see have about the same hours as physicians, but instead of raking in major profits from their practice like the physicians, they are rather well paid employees. So the docs sit on $400k+ wages and tax breaks, and PAs draw $100k and maybe a bonus if they are productive. Some people see the wage issue as a demonstration of how much respect you are getting, but I'm not sure that's a respect issue, but an issue of who went to more school and who carries more expertise.

Ive seen plenty of physician only lounges, and by that they mean physicians only.

Then there are staff. My facility isn't full of jerk nurses who would treat a PA badly. But the economics of time dictate that a physician walking in gets more of my kid gloves than any other provider, if only because they are the business owners that the facility depends on to drive work our way, and sign the contracts. PAs don't operate in that role. It's just a matter of recognizing who the boss is. Maybe some folks pick up on that and it chafes a bit. As far as patient care goes, an order is an order, and I usually see whoever is writing them as an asset, no matter what their pay rate is. If a PA is writing for a HAB when I need it for a patient, they are as useful to me as a physician.

What numbers are you getting that from? In state PA schools are roughly 50k a year. For two years is 100k? Are you looking at expensive private schools?

 

[paolakit]

Thank you Makati2008 and pamac for sharing!
I agree Dentalguy8621 ; The most expensive I've come across is USC's program..roughly $150k total (private institution, tuition only); so this is not the norm.

 

[Makati2008]

Thank you Makati2008 and pamac for sharing!
I agree Dentalguy8621 ; The most expensive I've come across is USC's program..roughly $150k total (private institution, tuition only); so this is not the norm.

Wow. After living expenses you would probably be in striking distance of my med school debt.

 

[pamac]

I flubbed the delivery on that. What I was trying to say was PA school loans for school and expenses usually runs about 100k total. Medical school itself is two more years and a bit over 200k. So double the cost and time just for medical school, but them years and years of far increased return in wages. That doesn't count residency of course.

 

[deleted6669]

Hello, can you expand on PAs lacking respect? Have you observed that first hand? Just curious, considering most PAs report high job-satisfaction and respect from supervising physician and team they work with. I have been reading a lot on PAs so I would like to know if lack of respect is just something PAs are not disclosing. Also, I understand the restrictions, but how do you determine a PA program is not worth the time/money investment? Is this relative to physicians? Thanks!

yup have seen it first hand many times over almost 20 yrs as a pa: nurses not taking pa orders, docs refusing to consult on the phone with a pa, being told "you are just a pa, ask a dr", doc makes a mistake it's a "complex case", pa makes same mistake "they are obviously poorly trained and a dr never would have missed that",etc.
this happens more in urban than rural settings. now I work solo and/or rural all the time so it has gotten much better.

 

[BestDoctorEver]

At my second job, we were allowed to eat with docs(for free) and shower there if needed, well during my time there they deactivated our badges where we could not use that part of the hospital.

A nice slap in the face , we were good enough to see your patients and make you money but can't eat in a lounge with our attending or alone. Also to me it was further irritating that the docs wouldn't go to bat for the midlevels and some even verbally agreed saying there are some things we might not want you to hear and sometimes it's good to have some things physician only to promote a collegial atmosphere with our peers....

That happened regarding parking spaces in a hospital that I used to work in FL. NP/PA are not allowed to park in the physician parking lot anymore... I was told by a couple of my friends who still work there that there are rumors that eating in the physician cafeteria with be the next 'privilege' they will take away from NP/PA... What was really weird is that my friends who are nurses seem to be very gleeful about these 'unnecessary' hospital policies.

 

[Makati2008]

That happened regarding parking spaces in a hospital that I used to work in FL. NP/PA are not allowed to park in the physician parking lot anymore... I was told by a couple of my friends who still work there that there are rumors that eating in the physician cafeteria with be the next 'privilege' they will take away from NP/PA... What was really weird is that my friends who are nurses seem to be very gleeful about these 'unnecessary' hospital policies.

I would be careful of those "friends" they would probably be the same ones to stab a physician in the back. Just saying....

 

[MrWilson]

My best friend is starting his last year of EM residency, and he's stated on several occasions that if he had the chance to do it over again, he would've gone the PA route, and honestly, I can't blame him. After all the years invested post-undergrad, considering the sacrifices of finances, time with family/friends, time to start a family, years of lost income + years of accumulated debt, etc - it makes sense to go the PA route. I'm in my last year of dental school, and I sometimes wonder if I had gone PA - and I don't even have to do a 3+ yr residency like MD/DO's. The time commitment for school and years of lost income have honestly made me sometimes second guess my route. Don't get me wrong, I absolutely love dentistry and everything it entails, and I will be reaping the rewards financially and have time for family 10 months from now...but it's a loooong road...and my best friend and I didn't come from well-to-do families with money and connections, like majority of our classmates.

Shadow and talk with various people in the profession. There are multiple factors to consider.

 

[badasshairday]

EMEDPA is part of the old guard of PA's. No you don't need exensive healthcare experience for PA school these days. You will get plenty of clinical hours at a good PA school. Go PA over MD, it is better.

Source: me, an MD.

 

[Makati2008]

EMEDPA is part of the old guard of PA's. No you don't need exensive healthcare experience for PA school these days. You will get plenty of clinical hours at a good PA school. Go PA over MD, it is better.

Source: me, an MD.

Gotta disagree. As someone who is doing residency (and believe me this is the hardest thing I have ever done-not due to the work but some of the narcissistic personalities) I wouldn't trade it to go back to being a PA due to more respect, better pay, and more knowledge.

But that's just me

 

[FutureOncologist]

I had the fortune of shadowing a PA back in my freshman year (6 years ago!) and he was a surgical PA. He had been in that hospital for quite a few years (I think 10+) and he pretty much said that he should have pursued an M.D. because

1. He was treated as a nurse, despite the amount of time he has been there (different doctors coming in and out, so no real reputation in the hospital that he works in)
2. If on an emergency case, 9/10 times a physician will only want to talk to another physician when making a call on the patient
3. He was in school for [drum roll]......... 8 years (although he did do EMT school for 2 years to earn the hours he needed to be considered to PA schools).
4. He pretty much does sutures and closes the patients if he gets any involvement in surgery. Most the time if a Med student/intern gets precedence on these procedures
5. When people look at his title "[Name Here], PA" they often ask "is that a kind of doctor?" followed by a 4 minute conversation about how he is more than an secretary to the doctor.

There are pros to being a PA, but overall, the fewer years and a little bit less cost wasn't worth it to become a PA.

 

[didymus]

I had the fortune of shadowing a PA back in my freshman year (6 years ago!) and he was a surgical PA. He had been in that hospital for quite a few years (I think 10+) and he pretty much said that he should have pursued an M.D. because

1. He was treated as a nurse, despite the amount of time he has been there (different doctors coming and out, so no real reputation in the hospital that he works in)
2. If on an emergency case, 9/10 times a physician will only want to talk to another physician when making a call on the patient
3. He was in school for [drum roll]......... 8 years (although he did do EMT school for 2 years to earn the hours he needed to be considered to PA schools).
4. He pretty much does sutures and closes the patients if he gets any involvement in surgery. Most the time if a Med student/intern gets precedence on these procedures
5. When people look at his title "[Name Here], PA" they often ask "is that a kind of doctor?" followed by a 4 minute conversation about how he is more than an secretary to the doctor.

There are pros to being a PA, but overall, the fewer years and a little bit less cost wasn't worth it to become a PA.

It all depends on what someone wants out of a career and out of life. For many people, being a surgical PA would be a sweet gig for $120,000+ a year, awesome benefits, less responsibility, much less training, incurred-debt, and opportunity cost. Not everyone cares if they have to explain what they do to people ignorant of the profession. Not everyone minds deferring more difficult cases and questions to a greater authority.

Again, it all depends on the individual and his or her personal goals and aspirations. To many who are just looking for a rewarding career with a great lifestyle and short overall training period, being a PA is the perfect choice.

 

[badasshairday]

There are pros to being a PA, but overall, the fewer years and a little bit less cost wasn't worth it to become a PA.

There are pros to being an MD, but overall, the vastly longer years and vastly more cost wasn't worth it to become and MD.

And your other points, I agree with didymus completely. Also as my wife is an ER PA, for the most part her patients call her "Doctor" even after she introduces herself as a PA and corrects them once. She will see all acuity for the most part, not just coughs and sore throats. She see's patients with chest pain (MI's), occasionally strokes. She sutures complex facial lacs that if you were at an academic program you would consult ENT on for repair like the lip vermillian border (and she does a damn good job at it). She does lumbar punctures and intubates patients. She works ~14 shifts per month and makes over 120K per year, 2 years out of school. Her job prospects are hot, being a PA these days is the HOT job. She had so many interviews in a competitive desirable city.

I on the other hand am over 200K in debt with interest accumulating at 6.8%, still in training in a highly specialized field and making ~55K per year. I, as well as some other highly specialized docs will have a hard time finding jobs in the locale that my wife works in because everyone is scared of obamacare, nobody is retiring, and instead of hiring a doc they rather hire a PA if they can get away with that. I can't switch specialties like she can. I still have to take more boards. I will have to answer to lawyers without a doubt at least one time in my career statistically. I have had to move numerous times so far, once for med school, once for residency, and will probably move again for fellowship. No stability.

 

[badasshairday]

Gotta disagree. As someone who is doing residency (and believe me this is the hardest thing I have ever done-not due to the work but some of the narcissistic personalities) I wouldn't trade it to go back to being a PA due to more respect, better pay, and more knowledge.

But that's just me

Yeah that is just you. Different strokes for different folks. My wife would never dream of leaving her career as a PA to go to med school ( I on the other had often fantasize going back in time and doing PA school, computer science, or dentistry). Also lets be honest, most women would not want to switch out of PA to go to medschool. It is a huge pain having to move for med school, then residency, then fellowship. People like to have at least somewhat normal lives, and an MD career really screws with that whether you are a man or woman ( more so if you are a woman in my opinion since a large part of your childbearing years are spent in a time in which you have little say in dictating your schedule).

 

[badasshairday]

1. He was treated as a nurse, despite the amount of time he has been there (different doctors coming in and out, so no real reputation in the hospital that he works in)
2. If on an emergency case, 9/10 times a physician will only want to talk to another physician when making a call on the patient
3. He was in school for [drum roll]......... 8 years (although he did do EMT school for 2 years to earn the hours he needed to be considered to PA schools).
4. He pretty much does sutures and closes the patients if he gets any involvement in surgery. Most the time if a Med student/intern gets precedence on these procedures
5. When people look at his title "[Name Here], PA" they often ask "is that a kind of doctor?" followed by a 4 minute conversation about how he is more than an secretary to the doctor.

1. Wife is treated as a PA in the ED. Her patients call her "doctor" despite introducing herself as "PA" and correcting once.

2. When the doc was running a pediatric code my wife went to go see the stroke. Being in the ED her cases are ED cases that need to be admitted, and 99/100 the Attending physician who is being consulted or asked to admit will talk to her, and her alone.

3. She was in school for....... 3 years after undergrad. She did a 3 year PA program which prepared her well. If she did the shortest residency traning possible as an MD she would have been in school/training for 7 years after undergrad. Dont' forget all those expensive tests, loans, moving around the country to places you may not even want to be for school/training.

4. She pretty much does all the procedures that the ED docs do. If she isn't comfortable with it the docs will teach her (like a resident, but she gets paid nearly 3x the amount).

5. When people look at her title "Name, PA" they call her doctor or know she is a PA. If they call her doctor after she introduces herself as PA she may make an effort to correct them once.. otherwise she just continues to treat since there is no time to chat for 4 minutes about a title in a busy ED.

 

[Makati2008]

Yeah that is just you. Different strokes for different folks. My wife would never dream of leaving her career as a PA to go to med school ( I on the other had often fantasize going back in time and doing PA school, computer science, or dentistry). Also lets be honest, most women would not want to switch out of PA to go to medschool. It is a huge pain having to move for med school, then residency, then fellowship. People like to have at least somewhat normal lives, and an MD career really screws with that whether you are a man or woman ( more so if you are a woman in my opinion since a large part of your childbearing years are spent in a time in which you have little say in dictating your schedule).

Just giving a small counter on why PA isn't the perfect solution for all. I won't speculate on what most women would do because I don't know .

 

[FutureOncologist]

You all have to assume that I shadowed one PA that was a Surgical PA. This is of course very circumstantial. He works in the only Level 1 trauma center in our city so there are a bunch of med students, interns, residents, and attendings that get priority on surgery cases (especially emergent) that come in and out. In no way am I bashing PA's. Honestly, if I wasn't so dead-set on going to Medical School and just wanted to be in the field in general, I would have gone for an NP or a PA position.

 

[didymus]

1. Wife is treated as a PA in the ED. Her patients call her "doctor" despite introducing herself as "PA" and correcting once.

2. When the doc was running a pediatric code my wife went to go see the stroke. Being in the ED her cases are ED cases that need to be admitted, and 99/100 the Attending physician who is being consulted or asked to admit will talk to her, and her alone.

3. She was in school for....... 3 years after undergrad. She did a 3 year PA program which prepared her well. If she did the shortest residency traning possible as an MD she would have been in school/training for 7 years after undergrad. Dont' forget all those expensive tests, loans, moving around the country to places you may not even want to be for school/training.

4. She pretty much does all the procedures that the ED docs do. If she isn't comfortable with it the docs will teach her (like a resident, but she gets paid nearly 3x the amount).

5. When people look at her title "Name, PA" they call her doctor or know she is a PA. If they call her doctor after she introduces herself as PA she may make an effort to correct them once.. otherwise she just continues to treat since there is no time to chat for 4 minutes about a title in a busy ED.

An excellent 3 posts-in-a-row, sir. I think it's true that right now, much of the public is fairly ignorant re: the PA profession. The mainstream news focus on physicians and NP's. Physician Assistants are rarely a part of the discussion, but I think over the next 10 years that will shift dramatically. As more and more NP's flood the market, lobby for independence, and make enemies out of more and more physicians, we will see PA's getting good press and good visibility. All of these things will be a boon for the PA profession, especially since the physicians I know of are quite favorable towards PA's, if for no other reason than they have a pretty intense disdain for NP's. The fact that PA's are trained in the medical model should be a confidence-builder among the physician-colleagues out there. Most of the PA's I know--and I've expressed this elsewhere--are pro-physician. PA's are not interested in working independently. They want autonomy, but seem to accept their limitations, and are actually trained to be a contributor to the medical profession, not some kind of lone ranger out there solving healthcare disparity problems.

Anyway, it really depends on the individual. There are tons of people who would not be comfortable with the professional and practical limitations inherent in the PA profession, and those people should go and become doctors. Most of them will make excellent clinicians, researchers, and leaders. Others are perfectly content with the limited scope of practice, limited responsibility, limited training, and limited--though quite satisfying--compensation. These people should become PA's, and they will contribute well as collaborators with the much more highly trained physician leaders they will work with.

 

[badasshairday]

I by all means am not telling anyone not to become a physician. Just make an informed choice. I think there are a ton of undergraduate students doing the premed route that do not even realize what a PA's job description is. If you are contemplating PA versus MD, don't go in with the mentality that I see some of the posters here say. They say, "you are young, go to med school." It is much more complex than that. Really consider PA school based on whether or not you want to be the end all be all or if you are okay with a slightly limited, but still fairly large scope. Really consider PA school if you want to be done training/school by the time you are 25 rather than 30+ and making a healthy 6 figure salary. Really consider PA school if you want to start family planning at a more "normal age" and don't want to be forced to move around for school, residency, fellowship or take leave of absence which will just exacerbate your training length and debt. These are real factors that undergraduate students do not think about. They think MD is money, power, and respect..... but at what cost? If you really want it go for it, but just know there is a lot of baggage that goes with it. Just food for thought.

 

[camtheman77]

Being on the army I work with PAs all the time and their awesome. But, I never want to hear the classic "Your not a doctor" but thats just me lol

 

[AnnoyedByFreud]

Hello All! Thank you for taking the time to read this post.

I have been very impressed by the wealth of knowledge on these forums!

I am a current college student. I have gained a renewed interest in healthcare as a primary care provider (in varying capacities...) and am very interested in going to PA school.

My plan, as of now, is to:
1. Finish my degree in the next two semesters, if possible.
2. Go back to school immediately to work on my prereqs for PA school (four semesters) while at the same time...
3. ...becoming certified as an EMT (two semesters) and then working as an EMT for 2000 hours (one year)
4. Apply to and get into PA School; work hard and finish

Overall this plan should take about 5 years.

But at the same time, I am wondering if after doing all this work to go to PA school, I would regret not trying for an MD.

I would just like opinions from people that know these fields or have experience with this dilemma. Also any advice on working towards PA school would be appreciated.

OP - I think there's another issue that's worth bringing up. Keep in mind that the people who are telling you to go to medical school are mostly male. If you're female (I'm assuming you are based on the pic), then you unfortunately have to consider whether or not it is worth it for you to spend your 20s/30s in medical school. The last study I saw found that female PAs actually out earn female MDs (this is for primary care), because of debt and opportunity costs. A female pediatrician (who practices out-patient primary care pediatrics) I know wishes she had become an NP, and it wasn't worth it for her to go through medical school. However, if you are extremely passionate about a surgical specialty, or if you have already have a partner who is very supportive of you going to med school, know whether or not you want kids and how you can fit that in, etc, etc, then medical school can definitely be a great decision. Just be sure to consider how important the next ~10-12 years are for your life trajectory as a whole... unfortunately for women we sometimes have less flexibility, depending on our goals.

 

[peudamour]

OP - I think there's another issue that's worth bringing. Keep in mind that the people who are telling you to go to medical school are mostly male. If you're female (I'm assuming you are based on the pic), then you unfortunately have to consider whether or not it is worth it for you to spend your 20s/30s in medical school. The last study I saw found that female PAs actually out earn female MDs (this is for primary care), because of debt and opportunity costs. A female pediatrician (who practices out-patient primary care pediatrics) I know wishes she had become an NP, and it wasn't worth it for her to go through medical school. However, if you are extremely passionate about a surgical specialty, or if you have already have a partner who is very supportive of you going to med school, know whether or not you want kids and how you can fit that in, etc, etc, then medical school can definitely be a great decision. Just be sure to consider how important the next ~10-12 years are for your life trajectory as a whole... unfortunately for women we sometimes have less flexibility, depending on our goals.

This is something I've been thinking about. You bring up some very good points about possibly making less money over the course of my career for the sake of a family and spending my most fertile years in medical school and residency. I've kind of come to the conclusion that pursuing a medical specialty might fit better with my personality and allow me to fulfill my academic potential.

Also, as much as I want to plan for the possibility of getting married and having kids (two things I really, really want), I don't know if settling for being a mid-level provider in preparation for having a family would satisfy me. As naive as it is, I'm hoping that maybe one day, I can have it all. I guess we'll see how this works out.

 

[demayette]

It all depends on what someone wants out of a career and out of life. For many people, being a surgical PA would be a sweet gig for $120,000+ a year, awesome benefits, less responsibility, much less training, incurred-debt, and opportunity cost. Not everyone cares if they have to explain what they do to people ignorant of the profession. Not everyone minds deferring more difficult cases and questions to a greater authority.

Again, it all depends on the individual and his or her personal goals and aspirations. To many who are just looking for a rewarding career with a great lifestyle and short overall training period, being a PA is the perfect choice.

120k+ is good money but is pale in comparison to ortho or Gen surgeon docs who are making 400k+... PA is a good career for people who don't want to commit the time to become MD/DO... However, people should not think for a second that most PA work 40hrs/wk and have golden time for themselves when many of them are employed by physicians...

 

[Perrotfish]

nvm

 

[FutureOncologist]

Guys, PAs are pretty amazing. The surgical PA I shadowed had more knowledge than some residents there. Was he treated like s**t? No, many nurses, doctors, and patients treated him with respect. I was only sharing what he told me and what I had noticed. It all depends on what program you do and where you work. There is a great need for PAs. I encourage everyone to look into both medical school (especially on how to pay for it, which includes scholarships), PA schools, and nursing. But don't let people tell you that medical school steals your glory years. Yes, you'll be "in school" for the rest of your life if you become a physician, but you will have some free time. I myself am about to start 3rd year rotations (just got my schedule ) and I do have free time to study and to hit the gym.

Also, please keep this in mind. No job is perfect. If you're keeping up-to-date with healthcare in the US, then you will find that more and more responsibilities are being given to NPs and PAs. I personally support it because we simply need more physicians in this country. But with the responsibilities (e.g. PAs may not need an MDs permission to prescribe medicine in the near future), it comes with new territory. If the example happens, then PAs may be required by hospitals to purchase Malpractice insurance, simply due to the fact that your signature, not the physicians, is on the chart. PAs then might need more hours to work in the hospital (because they are pretty much doctors with different letters), which means more charting. PA schools will start having requirements that look similar to medical school requirements and may introduce rotations tacked on at the end of schooling. I can go on from here.

I am aware that this is a slippery slope fallacy, but in all honesty, I can see this happening.

 

[demayette]

With the expansion of PA schools, I strongly advise people to do their research before trying to get into PA school... I think PA school is heading the way pharmacy did 5+ years ago...

 

[didymus]

With the expansion of PA schools, I strongly advise people to do their research before trying to get into PA school... I think PA school is heading the way pharmacy did 5+ years ago...

There are tons of PA schools, yes--but most of the class sizes are relatively small (especially compared to medical school class sizes), and we are far from remedying the healthcare provider shortage in this country, so I wouldn't sound the alarm quite yet (not that you were, but I could see how some may interpret it that way).

The PA profession is still a pragmatic option, especially so in the midst of our tenuous healthcare system, since it is still only a two-year masters degree, which means students aren't yet taking on unsustainable debt to train as PA's, and the salaries are pretty decent. Once the profession trends to a doctorate degree and requires students to shell out >$150K for school, we will have reached the point of serious concern.

Thankfully it hasn't come to that yet!

 

[Mad Jack]

There are tons of PA schools, yes--but most of the class sizes are relatively small (especially compared to medical school class sizes), and we are far from remedying the healthcare provider shortage in this country, so I wouldn't sound the alarm quite yet (not that you were, but I could see how some may interpret it that way).

The PA profession is still a pragmatic option, especially so in the midst of our tenuous healthcare system, since it is still only a two-year masters degree, which means students aren't yet taking on unsustainable debt to trim as PA's, and the salaries are pretty decent. Once the profession trends to a doctorate degree and requires students to shell out >$150K for school, we will have reached the point of serious concern.

Thankfully it hasn't come to that yet!

The debt to income ratio of many PAs in the Northeast is about the same as most newly minted MDs due to the crazy COA many private schools have. The other thing to consider is that the number of PAs graduating per year is growing faster than demand, especially with APRN competition factored in.

 

[badasshairday]

I appreciate the discussion but it seems that you have a very superficial understanding of the PA profession (as do many people), which is partly why I am posting on this thread to dispel misconceptions.

But with the responsibilities (e.g. PAs may not need an MDs permission to prescribe medicine in the near future), it comes with new territory.

PAs do not need an MD'S permission to prescribe medicine already. They sign there own prescriptions, and they have done this for quite some time. I know PAs in EM and IM personally and they write whatever they want for their patients. The EM ones see patient's solo and discharge them with whatever med is needed without MD input. The IM ones I know have their own panel of patients independent from there "supervising" physician.

If the example happens, then PAs may be required by hospitals to purchase Malpractice insurance, simply due to the fact that your signature, not the physicians, is on the chart.

Their name is on the charts already and they already are required to have their own malpractice insurance. My wife has malpractice insurance in a group plan just like all her other PA and physician colleagues in her group.

PAs then might need more hours to work in the hospital (because they are pretty much doctors with different letters), which means more charting. PA schools will start having requirements that look similar to medical school requirements and may introduce rotations tacked on at the end of schooling. I can go on from here.

They already do all the charts. Also PA schools have rotations which take place during the last half of their schooling.

I am aware that this is a slippery slope fallacy, but in all honesty, I can see this happening.

It has already happened.

 

[FutureOncologist]

I appreciate the discussion but it seems that you have a very superficial understanding of the PA profession (as do many people), which is partly why I am posting on this thread to dispel misconceptions.



PAs do not need an MD'S permission to prescribe medicine already. They sign there own prescriptions, and they have done this for quite some time. I know PAs in EM and IM personally and they write whatever they want for their patients. The EM ones see patient's solo and discharge them with whatever med is needed without MD input. The IM ones I know have their own panel of patients independent from there "supervising" physician.



Their name is on the charts already and they already are required to have their own malpractice insurance. My wife has malpractice insurance in a group plan just like all her other PA and physician colleagues in her group.



They already do all the charts. Also PA schools have rotations which take place during the last half of their schooling.



It has already happened.

I didn't know this! Thank you for keeping me informed! I shadowed 6 years ago and being already in med school didn't really keep up with the PA profession.

 

[deleted6669]

b.a.h.d.
-Thank you for adding some perspective based on your wife's job. I work 3 jobs.
1 of the 3 is basically what you describe: double coverage with a doc alternating charts. I can be intubating a drug od while they are seeing a kid with a cold.
Job #2 is very rural with solo coverage of the E.D. There is a back up FP hospitalist who will come in for admits but otherwise I am there seeing every pt and responding to floor emergencies, directing ems, etc. Volume is less than 20 pts/24 hrs with a very high admit and transfer rate as the typical pt is > 70 yrs old.
Job #3 is an underserved urban satellite e.d., also solo coverage.

The big problem with the PA profession is lack of recognition and respect. I have 10 years of post high school education and am frequently thought of as an "assistant" unless I work very rural or in high autonomy settings. In those settings the jobs exist for PAs because no docs are willing to work in the middle of nowhere for less than 100 dollars/hr. I am very happy making $65-85/hr. but do have to drive 3 hrs outside a major metro area to do so.
At my last job interview(#2) I didn't even ask what the pay rate was. I knew I wanted the job, knew what I was worth, and would have taken the job for 50% of the rate they ended up offering me due to the scope of practice, autonomy, and respect present there.

 

[TactFR44]

An excellent 3 posts-in-a-row, sir. I think it's true that right now, much of the public is fairly ignorant re: the PA profession. The mainstream news focus on physicians and NP's. Physician Assistants are rarely a part of the discussion, but I think over the next 10 years that will shift dramatically. As more and more NP's flood the market, lobby for independence, and make enemies out of more and more physicians, we will see PA's getting good press and good visibility. All of these things will be a boon for the PA profession, especially since the physicians I know of are quite favorable towards PA's, if for no other reason than they have a pretty intense disdain for NP's. The fact that PA's are trained in the medical model should be a confidence-builder among the physician-colleagues out there. Most of the PA's I know--and I've expressed this elsewhere--are pro-physician. PA's are not interested in working independently. They want autonomy, but seem to accept their limitations, and are actually trained to be a contributor to the medical profession, not some kind of lone ranger out there solving healthcare disparity problems.

Anyway, it really depends on the individual. There are tons of people who would not be comfortable with the professional and practical limitations inherent in the PA profession, and those people should go and become doctors. Most of them will make excellent clinicians, researchers, and leaders. Others are perfectly content with the limited scope of practice, limited responsibility, limited training, and limited--though quite satisfying--compensation. These people should become PA's, and they will contribute well as collaborators with the much more highly trained physician leaders they will work with.

I can't tell you how I excited I am to be applying to PA school! The best decision I have made. Your reasons above mirrored exactly what I wanted out of a medical career. Not everyone cares to become a doctor.