MD vs PA

[similarswordfish]

I’m a junior (planning on taking a gap year regardless of which route I take), and for the life of me I cannot make this decision.

I call myself pre-med, I’ve been pre-med since starting college, and I’ve followed all of the pre-med coursework and advice I possibly could. Every couple months, PA school creeps back into my head and makes me question everything, and It’s getting to be crunch time. The lateral mobility, shorter timeline, and increased direct patient contact really fits with what I (currently) want out of life. That being said, my mother is a mid-level practitioner who somewhat regrets not taking the physician path due to limitations she faces in her scope. I’m terrified of regret, and I don’t want to realize decades down the road that I should’ve gone to med school. If I’m being totally honest, the academic validation of having a doctoral degree also plays a part in my thought process. Part of me thinks if I’m going to go in, I might as well go “all in” (med school).

I’m feeling very lost and would love some insight from med students, physicians, PA students, or PA’s who struggled with the choice between the two paths.

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[Meerkatology]

depend on ur grades/ability?

if u have the grades/scores etc to conformtably be accepted to md school then do it

not much else to say there.

they talk about midlvl encroachment in medicine like its doomsday, but all i know is i work
half as much as the midlvls in my hospital and (probably) make twice there salary.

the extra years(and debt) is still worth it

 

[LizzyM]

Your mother could be my brother.... Totally agree that med school admission depends in large part on grades/scores and experiences.
PA school will, I think, have lower expectations for grades/scores but seems to have higher expectations with respect to clinical experience. So, you could be a better candidate for MD /DO than for PA depending on what you've been doing.

A big part of the draw is often the shorter route which does mean lower out-of-pocket costs and a paycheck sooner for PAs vs physicians but on the flip side, that paycheck is almost sure to be smaller.

The amount of patient contact is up to you as a physician depending on the specialty you choose and the type of practice you go into.

The ability to move laterally is far greater for PAs. My brother has done internal medicine, urgent visits and sports medicine/ortho over a 30+ year career. It keeps things interesting but he does have regrets....

You get one life, choose wisely.

 

[JAK2-STAT3]

Have you shadowed physicians and PAs?

Are you okay with not being an expert? With there always being someone who knows more about what you do than you do? With having a less in-depth understanding of why you are doing what you are doing? With not being a leader in patient care? This is very personal, and there isn't a right answer.

For me, devoting years of training and study to being an eventual expert at what I do was part of my draw to medicine. I wanted to not just be a leader, but spend years of blood, sweat, and tears of honing my craft and knowledge base so that one day I can be a competent expert who is worthy of leading a patient's care. I enjoy learning physiology, pharmacology, pathology, etc. If a patient has a disease, I want to know what is causing that disease, what that disease looks like under a microscope, and why we would give the medication we would give for that disease. Not everybody thinks this way, and that's perfectly okay. If you're okay with not being the leader of a care team while still knowing a decent amount of stuff, making good money, and working normal business hours then being a PA could be a good option.

 

[Splenda88]

My two cents.

You should choose MD/DO over NP/PA if you are < 30 yrs old.

I was a RN for ~8 yrs and started med school in my mid 30s... boy! I am glad I did choose MD over NP.

I am in state where NP/PA do not have full practice authority and you could sense the frustration when they are facing with things ONLY physicians can do (eg., pronounce someone, Rx narcs etc...), and sometimes patient refusal to be seen by NP/PA.

I supervise NP/PA for 1 week ~5 times/yr and sometimes nurses would bypass them and call me directly because of trust issue

A strange thing happened at my hospital 1 1/2 yr ago. Administration decided to no longer allow mid levels to use the physician dining room (aka no more free food, Starbucks etc...). They sent a mass email to ALL "providers" saying they were cutting NP/PA dining room privilege due to cost issue. NP/PA were pissed.

The other thing is knowledge base. I supervise both NP/PA and the difference in knowledge is HUGE. When it comes to NP vs. MD, there is no comparison.

Salary is another thing to consider. I work 1 week on/off as a hospitalist and if I decide to work 1 week on and 3 wks off, my salary will still be 40k+/yr more than our NP/PA even if they work the typical 1 wk on/off.

 

[OMSRealWeebHours]

depend on ur grades/ability?

if u have the grades/scores etc to conformtably be accepted to md school then do it

not much else to say there.

they talk about midlvl encroachment in medicine like its doomsday, but all i know is i work
half as much as the midlvls in my hospital and (probably) make twice there salary.

the extra years(and debt) is still worth it

How do you pull that off? Do you not have as much paperwork or patient charting

 

[LunaOri]

You are not ready to make a decision. Shadow both professions, and spend your gap year working in a clinical setting so you can get a sense of what physicians do.

 

[Mammothhighway]

You are not ready to make a decision. Shadow both professions, and spend your gap year working in a clinical setting so you can get a sense of what physicians do.

This is probably the best advice tbh, as it is a huge decision. I also think academic validation of a doctoral degree should not be a push towards med, and that you should want med bc you want to be a doctor, not be called a doctor.

My general rule of thumb has been if your not sold on taking the physician route you shouldn’t buy in. The loans/work/years of education and training are too intimidating for me if i was unsure of what I wanted to do, but that’s just my view on it.

Regardless, you have time so I would not stress too much. Do some research, shadow some people and try to think about what you could imagine for your lifestyle in the future

 

[Mr.Smile12]

Older article to read (2014), explaining the "expertise" differences

From PA to MD: An appreciation for physician education

It was common, and I am sure it still is, for us, as PA students, to talk of PA school as comparable to medical school.

www.kevinmd.com

 

[Meerkatology]

How do you pull that off? Do you not have as much paperwork or patient charting

I work nights thats part of it lol

 

[OMSRealWeebHours]

I work nights thats part of it lol

Time sounds ideal but does that screw with your mind to be on that schedule? I had certainly contemplated a role like that with less hours but I got scared off because some people said long-term it screws with lifespan or something

 

[Meerkatology]

Time sounds ideal but does that screw with your mind to be on that schedule? I had certainly contemplated a role like that with less hours but I got scared off because some people said long-term it screws with lifespan or something

I sleep pretty well i just do it during the day time on a consistent schedule. I dont know if this lifestyle has any long term health effect.

At 39 i do feel like my mind isnt what it was in my 20s; i dont know if its just part of getting older or something to do with the lifestyle

Will find out in the future i guess

 

[LizzyM]

I sleep pretty well i just do it during the day time on a consistent schedule. I dont know if this lifestyle has any long term health effect.

At 39 i do feel like my mind isnt what it was in my 20s; i dont know if its just part of getting older or something to do with the lifestyle

Will find out in the future i guess

Consequences of Shift Work and Night Work: A Literature Review

Nonstandard work schedules such as shift work and night work tend to trigger problems for workers in different areas. To illustrate the diversity of areas affected and the relative interest of the scientific community, we conducted a literature review ...

www.ncbi.nlm.nih.gov

It does.

 

[jhmmd]

There's shiftwork in certain medical specialties like EM and there's shiftwork in midlevel positions. Don't choose a career path assuming that you know what the parameters of your job will be like.

Doctor vs. PA comes down to a couple factors:
-Leadership. Do you want to LEAD the healthcare team or simply be a part of it?
-Accomplishment. Do you want to know some stuff or be an expert?
-Salary. Are the extra years and lifelong learning implication worth it, or are you satisfied with a smaller piece of the pie?

I agree with what others have said; do some more shadowing and come back here. Also talk to the people that you shadow about their day-to-day lives and what it was like training.

Graduate school is not the same as doctoral-level healthcare classes so you may be in for a rude awakening, if that's what you're expecting. Be sure that your expectations match reality.

 

[Meerkatology]

Consequences of Shift Work and Night Work: A Literature Review

Nonstandard work schedules such as shift work and night work tend to trigger problems for workers in different areas. To illustrate the diversity of areas affected and the relative interest of the scientific community, we conducted a literature review ...

www.ncbi.nlm.nih.gov

It does.

looked over the article since im interested in this. it does mention "greater effect occuring with people who switch between day and nights, while resynchronization occurs with people on a fixed night schedule" which is what i am. it mentions several areas of health with increased RR but doenst actually say how much. would be interested to see if any studies about night work on a fixed schedule like mine.
well i've been doing this for 10 years, if there's damage, its probably already been done