MD vs. PA, What is the best option?

[optimistic3]

This has been an interesting thread. I have finally decided that I no longer want to become and MD/DO and now I am looking into PA as a possible career choice. I know that I have loved all of the PAs I've seen in my doctors' offices (when I've been a patient) though I noticed some worked differently. I had some (primary care and derm) where I only saw that PA and never saw the MD/DO and I've had PAs in a specialist's office who would see me before the doctor, relay my issues to the doctor and then come back into the room with me and the doctor. I really liked that, actually. I felt like I had a lot more time to talk to the PAs and they made sure to have all my issues taken care of even if I had forgotten about them by the time the doctor walked in.

The lack of respect thing certainly does concern me a bit. Even my father gets confused when he is at a doctor appointment with me and the PA. I think I can understand, though. If I had not been premed all through undergrad, I don't think I would know what a PA was until I had seen them as a patient.

I do have one question - how difficult are the academics of PA school? The rigor of the first two years of med school definitely do scare me so I'm wondering how that compares to PA school. I'm not expecting to be able to fly through; I certainly am willing to work hard but one of the things that scared me away from med school is that I'm doubting my ability to make it through M1 and M2.

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[TactFR44]

This has been an interesting thread. I have finally decided that I no longer want to become and MD/DO and now I am looking into PA as a possible career choice. I know that I have loved all of the PAs I've seen in my doctors' offices (when I've been a patient) though I noticed some worked differently. I had some (primary care and derm) where I only saw that PA and never saw the MD/DO and I've had PAs in a specialist's office who would see me before the doctor, relay my issues to the doctor and then come back into the room with me and the doctor. I really liked that, actually. I felt like I had a lot more time to talk to the PAs and they made sure to have all my issues taken care of even if I had forgotten about them by the time the doctor walked in.

The lack of respect thing certainly does concern me a bit. Even my father gets confused when he is at a doctor appointment with me and the PA. I think I can understand, though. If I had not been premed all through undergrad, I don't think I would know what a PA was until I had seen them as a patient.

I do have one question - how difficult are the academics of PA school? The rigor of the first two years of med school definitely do scare me so I'm wondering how that compares to PA school. I'm not expecting to be able to fly through; I certainly am willing to work hard but one of the things that scared me away from med school is that I'm doubting my ability to make it through M1 and M2.

It's extemely competitive to gain admission to a PA program. Work on your HCE as soon as possible. Average gpa is 3.6. Many require organic and biochem now. PA school is rigorous. Check out inside PA training and watch the video of Sundance. She was a medical school student and took a leave of absence during clerkship after she had her baby. She began PA school soon after. Her story is great. She explains what you are asking here. Good luck! Many of my pre med friends are now pursuing PA school. It's crazy how popular it's becoming. Best of luck to you.

 

[optimistic3]

It's extemely competitive to gain admission to a PA program. Work on your HCE as soon as possible. Average gpa is 3.6. Many require organic and biochem now. PA school is rigorous. Check out inside PA training and watch the video of Sundance. She was a medical school student and took a leave of absence during clerkship after she had her baby. She began PA school soon after. Her story is great. She explains what you are asking here. Good luck! Many of my pre med friends are now pursuing PA school. It's crazy how popular it's becoming. Best of luck to you.

Thank you for your response! I did my BS in biochem so I'm good with that. I took a look at the prereqs for a few schools and it looks seems I will need a few more classes (anatomy, physiology, stats, and medical terminology) though I do have a lot more schools to look into. I have not taken the GRE so there's that, too. I absolutely do need to work on HCE; maybe I'll take an EMT class. I will definitely look into those things that you mentioned.

One quick question - what do PA schools do with repeated courses? Do they replace the grades like DO schools, average them like MD schools, or something else? I retook 2 classes this semester with the goal of DO school so I'm not sure what they'll do with that.

 

[TactFR44]

Thank you for your response! I did my BS in biochem so I'm good with that. I took a look at the prereqs for a few schools and it looks seems I will need a few more classes (anatomy, physiology, stats, and medical terminology) though I do have a lot more schools to look into. I have not taken the GRE so there's that, too. I absolutely do need to work on HCE; maybe I'll take an EMT class. I will definitely look into those things that you mentioned.

One quick question - what do PA schools do with repeated courses? Do they replace the grades like DO schools, average them like MD schools, or something else? I retook 2 classes this semester with the goal of DO school so I'm not sure what they'll do with that.

No grade forgiveness. It is what it is.

 

[optimistic3]

No grade forgiveness. It is what it is.

Alright, thank you! I have a lot of research to do. I watched the Sundance video on YT, by the way, and it was great to hear that perspective. Thanks again for recommending it : )

 

[TactFR44]

Alright, thank you! I have a lot of research to do. I watched the Sundance video on YT, by the way, and it was great to hear that perspective. Thanks again for recommending it : )

No problem. Best of luck to you! Future PA colleague

 

[W19]

Thank you for your response! I did my BS in biochem so I'm good with that. I took a look at the prereqs for a few schools and it looks seems I will need a few more classes (anatomy, physiology, stats, and medical terminology) though I do have a lot more schools to look into. I have not taken the GRE so there's that, too. I absolutely do need to work on HCE; maybe I'll take an EMT class. I will definitely look into those things that you mentioned.

One quick question - what do PA schools do with repeated courses? Do they replace the grades like DO schools, average them like MD schools, or something else? I retook 2 classes this semester with the goal of DO school so I'm not sure what they'll do with that.

It seem likes it will take you at least 1-2 year to get into PA school and the majority of PA programs are over 2 years (2 1/2 years); therefore, it will take you about 4+ years to become a PA, which is about the same time it will take you to graduate DO school... I suggest you shadow both MD/DO and PA so you can make that choice wisely. If you think you will be ok to function in the PA capacity, it's ok to go PA. I worked with two PA who told me they went PA because the 2 1/2 year was attractive, but they regret it because they can't call the shot, their salary is a 1/3 of their supervising physician and they get the occasionally 'I don't want to be seen by a PA' from some patients... Good luck with whatever you decide...

 

[optimistic3]

It seem likes it will take you at least 1-2 year to get into PA school and the majority of PA programs are over 2 years (2 1/2 years); therefore, it will take you about 4+ years to become a PA, which is about the same time it will take you to graduate DO school... I suggest you shadow both MD/DO and PA so you can make that choice wisely. If you think you will be ok to function in the PA capacity, it's ok to go PA. I worked with two PA who told me they went PA because the 2 1/2 year was attractive, but they regret it because they can't call the shot, their salary is a 1/3 of their supervising physician and they get the occasionally 'I don't want to be seen by a PA' from some patients... Good luck with whatever you decide...

Yes, this is true. All those downsides of PA school are things I'm considering so hopefully I can find a PA soon to shadow. It seems to have a much greater life balance than med school or residency and that's something that I really want. I don't want to be engulfed in work 24/7 for the next 7-10 years like med students and residents seem to be. 2 years is much more reasonable. I want more free time to enjoy my life outside of my career (I know that sounds naive but I'm talking about ideals here). I will also be looking into other master's programs to see what's out there that interests me. I've also had many physicians tell me not to go to med school, probably about the same number of those who encouraged me to go so there's something to be said about that as well.

I appreciate your reply!

 

[TactFR44]

It seem likes it will take you at least 1-2 year to get into PA school and the majority of PA programs are over 2 years (2 1/2 years); therefore, it will take you about 4+ years to become a PA, which is about the same time it will take you to graduate DO school... I suggest you shadow both MD/DO and PA so you can make that choice wisely. If you think you will be ok to function in the PA capacity, it's ok to go PA. I worked with two PA who told me they went PA because the 2 1/2 year was attractive, but they regret it because they can't call the shot, their salary is a 1/3 of their supervising physician and they get the occasionally 'I don't want to be seen by a PA' from some patients... Good luck with whatever you decide...

Depends if that matters to you. Its not just 2.5 years. More like 2 versus 7. I want to enjoy my life. Not be drowned in work up to my eyeballs. It depends on what you want in life. Im cool with six figures, more travel time, less responsibility, more time for family, less malpractice inurance and less headache/anxiety/paperwork, some like that. Depends on you.

 

[TactFR44]

Yep.

 

[freespirit47]

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.

Hello, I am a student in a similar position deciding between MD/PA and I wanted to know if you still feel that PA might be a better choice considering the decent salary and less schooling. I am a female which should not matter but do not want to have children during residency which would mean waiting until I'm at least 35 y/o, making PA more appealing for family reasons. However everyone I speak to thinks I'm loosing an opportunity by not going to medical school (which is driving me nuts lol) and to be honest I feel I might regret not going. I think deep down my ego, salary, and the "respect/authority" of a physician compared to a PA's is the only reason I really want to go to medical school. I have shadowed both physicians and PAs and am still undecided. Any insight would be greatly appreciated.

 

[pamac]

Everyone wants to be a chief, and is terrified of the prospect of just being an Indian. So instead of going to two years of school, we are all tempted by 4 years + whatever residency entails. Then, you have to factor in the student debt to pay back. So when you say you would delay children until after residency, how do you expect to deal with life after your training, where you are a new provider with bills to pay, and practice to establish. Are you going to go through all that work just to yearn for the day when you can afford to cut back to part time to hang out with your kids?

Take emotion out of the equation and just look at it from the perspective of your personal life, and what career best supports your goals there. Don't worry about the opinions of people you don't even know yet (the people at work that you are afraid won't give you due deference). I've noticed that a lot of us on forums are male, and have type-A personalities (or claim to when we get in front of a keyboard). We are probably a lot more focused on professional respect issues than others. You might be surprised at what kind of environment you walk into as a PA.

 

[VegasPreMed]

Randomly stopping in here, but I'll give my two cents from scribing in Las Vegas, Nevada:

PA's and NP's at the EDs I work in do NOT see acute patients. At all. They see the "Fast Track" (in other words, Urgent Care) patients only. Exclusively. They never intubate. They never do complex lac repairs. They do not see stroke patients. They do not see overdose patients.

Some occasionally get to do fracture resets (but the only one who was allowed to used to be an ortho PA). Otherwise it's your bread and butter Urgent Care patients. All of the doc's see the PA's patients before they are discharged. Every last one.

I work at three different EDs in the valley (and with doctors who work at trauma centers who I asked precisely about this when I was deciding between PA or MD/DO), so I know this is not exclusive to a single hospital. I wanted to give a perspective from nonacademic hospitals for comparison for anyone reading and deciding between MD/DO or PA.

 

[pamac]

I think to a large extent you are right, but with some caveats. You are in a very urban environment, and in the largest metro area in Nevada. ED providers want to work there because they and their families want to live in nice suburban communities with access to a big infrastructure. They have no issues with staffing physicians, and set up their workload accordingly. Supply is good, so they can run with that.

There are more issues that get people admitted to the hospital, and as a nurse, I get admissions from PAs and NPs from the ED all the time, even when I'm working in an intensive care unit. But never seen one run a code or doing any of the really heavy stuff, so they must have some understanding about who takes the really tough cases like you say. But where I'm at I see everyone taking urgent care (or BS) patients, which form the vast majority of ER visits anyway. Essentially, I kind of proved your point, but I'm just wanting to add that there is more to the picture when you consider that in an ER, every provider deals with the scut work, and it's not just the non physicians.

I don't feel like it's a bad decision for folks to pursue PA school as a first job instead of becoming an MD. The difference is two fold. For one, it's easier to get into PA school.... It just is. In my undergrad, it seemed the smartest kids with the best grades went to PA school, but that doesn't mean much because that's personal experience. But just glancing at stats and looking in at the acceptance page on the PA forums, it seems like things have changed when folks with cumulative GPAs are starting to run just above 3.0, and are fielding interview invites from pretty good schools. Second, it's two years, and then on to work. Residency is several years of scut work and training, and little or no control over schedule and the location you'll be training at. That's not what everyone is up for. I see the same thing with nurses. Many are fine with where they are. I'm always surprised at folks who don't have any intention to move on to become an NP. My hospital will pay for school, and work with schedules, and still people won't take classes. People are motivated by different things.

 

[VegasPreMed]

But where I'm at I see everyone taking urgent care (or BS) patients, which form the vast majority of ER visits anyway.

Totally agree. All the doc's have to see the Urgent Care patients eventually as well; I was more just mentioning how it is where I work due to the earlier comments regarding PA's doing procedures. I'd say about half of the patients we seen in a day could be seen at an Urgent Care.

Second, it's two years, and then on to work. Residency is several years of scut work and training, and little or no control over schedule and the location you'll be training at. That's not what everyone is up for.

Again, agree. PA is a great route if you are looking for a quick path to treating patients. The acuity they generally see, however, may leave some feeling a bit bored. If you are young, I would say go to med school. But some people don't want the responsibility and would prefer to be more of a mid-level role. Nothing wrong with that! I have friends that went PA and are very happy.

 

[pamac]

I feel like if an NP or PA were taking on significantly acute patients regularly in that setting, it would be a bit of a ripoff. Either the PA is underpaid or overworked in that situation. Might be nice for the ego, but who wants to be doing that for very long. Its analogous to the nurses who crave flight nursing, but are making less than me working in a hospital. That's if you ignore the fact that its great experience.

 

[deleted6669]

I feel like if an NP or PA were taking on significantly acute patients regularly in that setting, it would be a bit of a ripoff. Either the PA is underpaid or overworked in that situation. Might be nice for the ego, but who wants to be doing that for very long. Its analogous to the nurses who crave flight nursing, but are making less than me working in a hospital. That's if you ignore the fact that its great experience.

I like the high acuity/low volume settings. I work solo now at 3 out of 4 of my jobs seeing all acuities, running codes, etc. What I don't want to do anymore is 40 fast track pts/day. would much rather work long rural shifts and see 12-15 fairly sick folks with a smattering of low acuity mixed in. I am fairly well compensated for the work I do, although it has taken me 20 years to get to where I am at today, 29 if you count the prior time as an er tech and paramedic. If I had to do it over again it would be medschool without a doubt.

 

[pamac]

You've always been motivated and have demonstrated it by the work you take on. You are fueled for that and seek it out, like the nurses who love flight.

Folks like yourself are drawn to the challenge. But I wonder how many people that like the challenge would want to keep doing it if it was expected as part of the job, and not rewarded with better pay. The facility gets the bargain, and the provider feels abused. Maybe not bored, but abused.

 

[Makati2008]

You've always been motivated and have demonstrated it by the work you take on. You are fueled for that and seek it out, like the nurses who love flight.

Folks like yourself are drawn to the challenge. But I wonder how many people that like the challenge would want to keep doing it if it was expected as part of the job, and not rewarded with better pay. The facility gets the bargain, and the provider feels abused. Maybe not bored, but abused.

They become like myself and go onto different avenues/careers.


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[Matthew9Thirtyfive]

Sorry to keep this thread going, but I didn't want to start a brand new one. Something emedpa said got me thinking. I have been planning on medical school, but PA has been in the back of my mind for numerous reasons.

Basically, I'm 31 years old, married with 2 kids, and about to complete my bachelors in math. I have 7.5 years experience as an OR tech before joining the Navy (not a medical rate, but I am on the medical training team and medical response team).

My reasons for medical school are not related to being "the final word." I'm interested in medical school because I want the greatest depth of knowledge and the opportunity to conduct research if I choose. However, I have been looking at PA because the salaries are good (anything over $60k is good for me since I will have very little debt), there is flexibility in switching specialties (I know it isn't necessarily as fluid as that, but much less difficult than as an MD I think), and the ability to practice right out of school even in fields like CTS and neuro without ridiculously long residencies. Basically, I would like to be able to function fairly autonomously in seeing patients, be able to do some procedures, and not be an indentured servant for most of my adult life. The idea of always having someone to check out with is kind of comforting actually, and I am not hung up on being called doctor (if I want that, I'll get my PhD -- kidding).

My wife supports me going to medical school, and my kids are used to me being gone (call is nothing compared to overnight duty q 3-6d when you add in being completely gone for months and months at a time). That said, I would like to be there for my family.

Any thoughts?