Med School to PA school

[SmithRock]

I am a medical student nearing the end of taking a year off after MS1 and am evaluating whether I am going to return to med school or switch and start the process to attend PA school. I was wondering if anyone on here has actually made the switch from the MD track to the PA track and what your perspective is regarding your decision.

Medicine is an interest of mine but is not the defining thing in my life. I would like to work in sports medicine (non-surgical) but don't really care a ton about autonomy and the thought of having to take call doesn't attract me at all. The thought of 6 or 7 more years of med school/residency busyness, stress and not much free time is not particularly appealing. However the "easier" route would be to stay in med school since I'm already in and applying to PA school would take more time and a few extra prereqs. Any pertinent informed thoughts? I would especially like to hear from people who actually switched from MD to PA. Thanks.

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[FutureCTDoc]

I would strongly advise against that course of action for several reasons. As an MD you have so much more latitude and flexibility to go into sports medicine. As a PA you don't necessarily have that ability. Being an MD/DO also allows you to A) Have increased practice rights B) More latitude in training (right now I'm gung-ho about Derm, by the time I match who knows?) especially if you decide after clerkships you really enjoy a surgical field C) Better ability to treat, even though a residency is long and difficult you gain so much more knowledge in it D) Pay is better as an MD/DO and you also have more respect, E) Although you may not value autonomy now, at 50 do you want to be answering to somebody with no hopes of ever being your own boss? Stick out the MD/DO route it's worth it, almost everyone asks why am I on this seemingly Quixotic quest.

 

[BruceBanner]

... E) Although you may not value autonomy now, at 50 do you want to be answering to somebody with no hopes of ever being your own boss? Stick out the MD/DO route it's worth it, almost everyone asks why am I on this seemingly Quixotic quest.

That's a great point, but a lot of people answer to a boss their whole life, even physicians. The exceptions would be docs who own their own practice or are a partner in a practice; but in academics you still answer to a dept chief, service chief, or chief of medicine.

I think the key point with autonomy is that PA's will always have limited diagnostic and decision-making authority, whereas MD/DOs' generally have ultimate treatment authority with thier own patients.

And in regards to lateral mobility, a PA can change specialties with relative ease, whereas an MD/DO would have to go back and do another residency.

Pay difference varies with specialty, obviously. My personal view is that there is a point where practicality trumps certain ambitions. If you want to be a non-surgical sports guy, how much more will you actually make as a doc compared to a PA in the same field? I actually dont know the answer, but if the difference is less than 100k you might want to think about having double the debt and quadruple the training time.

I'm not saying one is better than the other. I oscillate between MD-PA on almost a daily basis, and I'm not even in school.

I guess as an impartial observer, I would say if you are already in med school, you should finish. There are other options besides clinical practice with an MD. Plus, if you were to leave, that's it. Med school is pretty much a once in a lifetime chance.

 

[deleted6669]

DUDE, you have the hardest yr of medschool done. stcik it out and do a cush family friendly fp residency with a night float pool then do a sports med fellowship and you are golden.
in your shoes there is no way I would drop out now.
chances are you would also have problems getting into pa school as well. requirements are different and you might even need some more prereqs. the competition now for pa school is similar to medschool with some programs having > 1000 apps for 30 seats.

 

[WDeagle]

DUDE, you have the hardest yr of medschool done. stcik it out and do a cush family friendly fp residency with a night float pool then do a sports med fellowship and you are golden.
in your shoes there is no way I would drop out now.
chances are you would also have problems getting into pa school as well. requirements are different and you might even need some more prereqs. the competition now for pa school is similar to medschool with some programs having > 1000 apps for 30 seats.

Actually first year is probably the easiest year of med school but i would otherwise agree with this post. By the time you get apply to PA school and finish you would probably have finished or just about be finished with med school. Of course as a PA you have no residency to complete. However, if i was you and i just wanted family med/ sports med i would study enough to make sure i pass class, boards, and know enough to be competent but wouldnt stress too much. Its not like your shooting for derm or something.

 

[deleted6669]

Actually first year is probably the easiest year of med school but i would otherwise agree with this post. .

The consensus among my physician colleagues is that ms 1 is the hardest as it is dry, basic science material, some of which seems like it has little to do with their future careers. ms 2 has more clinical correlation and therefore is more interesting and ms3/4 are hands on learning so can be a time challenge but at least they are interesting.

 

[lapelirroja]

I would strongly advise against that course of action for several reasons. As an MD you have so much more latitude and flexibility to go into sports medicine. As a PA you don't necessarily have that ability. Being an MD/DO also allows you to A) Have increased practice rights B) More latitude in training (right now I'm gung-ho about Derm, by the time I match who knows?) especially if you decide after clerkships you really enjoy a surgical field C) Better ability to treat, even though a residency is long and difficult you gain so much more knowledge in it D) Pay is better as an MD/DO and you also have more respect, E) Although you may not value autonomy now, at 50 do you want to be answering to somebody with no hopes of ever being your own boss? Stick out the MD/DO route it's worth it, almost everyone asks why am I on this seemingly Quixotic quest.

Yeah I'm gonna go ahead and say PAs definitely win in terms of lateral mobility. No clue where you got that idea...

 

[BruceBanner]

I think another thing to consider is that the more time you take off from school, the more difficult going back is. You get to work and make some money, dont have the weekly stress of exams, and--the best part---when you come home for the day, youre done. No studying, no homework.

If you applied to a PA prgram you'd be looking at another year before you started, and by the time you finished you would have been done with med school.

 

[ArkansasRanger]

I am a medical student nearing the end of taking a year off after MS1 and am evaluating whether I am going to return to med school or switch and start the process to attend PA school. I was wondering if anyone on here has actually made the switch from the MD track to the PA track and what your perspective is regarding your decision.

Medicine is an interest of mine but is not the defining thing in my life. I would like to work in sports medicine (non-surgical) but don't really care a ton about autonomy and the thought of having to take call doesn't attract me at all. The thought of 6 or 7 more years of med school/residency busyness, stress and not much free time is not particularly appealing. However the "easier" route would be to stay in med school since I'm already in and applying to PA school would take more time and a few extra prereqs. Any pertinent informed thoughts? I would especially like to hear from people who actually switched from MD to PA. Thanks.

I think you're nuts. You'll probably have to do more studying in your off-time in PA school because you cover a lot, all day, and in a shorter time span. In the time it would take you to apply and get accepted to PA school then graduate you'd be wrapping up medical school. Ok, so then you've got to take a residency as a doctor. Big deal. Pick something cushy if you want or pick something hard. Do an AHEC FP residency with a sports medicine fellowship, or don't do anything after your intern year and hope for a job that way. Regardless, you're going to get paid and get going with life so suck it up. No sympathy.

 

[ArkansasRanger]

Yeah I'm gonna go ahead and say PAs definitely win in terms of lateral mobility. No clue where you got that idea...

Not really. It's like any other job. If you graduate and work in GI for four years or so and then all of a sudden you decide to go ER then you're going to have apply against others just as in any other occupation. It's like going from an account manager at company A and moving into HR in company B. It can be done, but you're going to be applying against a pool of people already working in that specialty thus less likely go get hired. I think the lateral mobility thing is too over rated.

 

[FutureCTDoc]

One other thing, you have to find an MD who is hiring a sports med PA. Most use PAs to do general work, well pt visits, routine vaccinations etc. I've never personally heard of a "Sports Med PA" also you are less likely to be allowed to treat interesting cases.

 

[275079]

Let's not get too rosy with the mobility of PAs. The following is just a sample of what people say. Besides, you think it's easy to be a PA in X specialty for 10 years, then just up and leave and go into Y specialty you know nothing about? Probably not a very wise career move to uproot yourself from all your knowledge base and start from scratch again - at the bottom.

I can't tell you how many times I've asked the PAs that I have worked with in the last year or so, "How did you pick your specialty?" Almost all of them told me, "Because that was the only job I could find that offered me decent money." I have yet to meet a PA that is working in his or her first choice. Yes, this is only anecdotal evidence at best... but it goes to show that all is not rosy in the PA world.

In Florida where I am, in theory, a PA can own his or her practice and "hire" a doctor to sign off on his or her charts. In reality, it doesn't work that way. PM me if you have questions. You will NEVER have the autonomy of of doctor and it isn't all that much harder to get a DO or MD than it is to become a PA.

Think long and hard before you make this decision.

http://forums.studentdoctor.net/showthread.php?t=632160

 

[deleted6669]

Let's not get too rosy with the mobility of PAs. The following is just a sample of what people say. Besides, you think it's easy to be a PA in X specialty for 10 years, then just up and leave and go into Y specialty you know nothing about? Probably not a very wise career move to uproot yourself from all your knowledge base and start from scratch again - at the bottom.

http://forums.studentdoctor.net/showthread.php?t=632160

There are really 2 classes of pa new grads; those with prior significant experience and those without. those with experience generally can find a job they are interested in and chances are it is related to their prior job:
paramedic to pa to em pa
rt to pa to pulmonology/critical care pa
oncology rn to pa to heme/onc pa
surgical tech/rn to pa to surgical pa
ortho tech to pa to ortho pa
etc

many of those without this prior experience have to take what is left after those with experience get their pick of jobs.
the pa ownership thing is very regional. I personally know/work with several pa's in my area who own their own clinics and hired an md supervisor. very common in north carolina and washington state for example.
regarding switching specialties I agree in part. certainly em to surgery or peds to oncology, etc would be a huge leap but pretty much anything to fp is easy because
1.the primary focus of our initial training was fp and we all are required to retake our boards which focus on this every 6 yrs regardless of which specialty we go into so we have to stay up on primary care.
2. there are tons of pa jobs in fp with just under 50 %( 48% ish) of pa jobs out there in primary care at this point.

 

[275079]

There are really 2 classes of pa new grads; those with prior significant experience and those without. those with experience generally can find a job they are interested in and chances are it is related to their prior job:
paramedic to pa to em pa
rt to pa to pulmonology/critical care pa
oncology rn to pa to heme/onc pa
surgical tech/rn to pa to surgical pa
ortho tech to pa to ortho pa
etc

many of those without this prior experience have to take what is left after those with experience get their pick of jobs.
the pa ownership thing is very regional. I personally know/work with several pa's in my area who own their own clinics and hired an md supervisor. very common in north carolina and washington state for example.

That's understandable. I think many people naively think that going PA means a world of opportunity unfolds - for less work. All the people you describe are anything but walk-ons. It really seems to be a career best suited for someone who doesn't want to go to medical school, but has already dedicated substantial time and/or effort into a dedicated area of health care already.

 

[deleted6669]

One other thing, you have to find an MD who is hiring a sports med PA. Most use PAs to do general work, well pt visits, routine vaccinations etc. I've never personally heard of a "Sports Med PA" also you are less likely to be allowed to treat interesting cases.

I know a few sports med pa's. most work for ortho , not fp groupsand most have completed postgrad pa residencies in surgery or ortho(see www.appap.org) and/or were previous athletic trainers.
in addition to clinic and o.r. work they do standbys at high school/college and professional sporting events. not a lot of these jobs out there and competition is fierce. we're talking probably 100 sports med pa positions in the country.

 

[SmithRock]

One other thing, you have to find an MD who is hiring a sports med PA. Most use PAs to do general work, well pt visits, routine vaccinations etc. I've never personally heard of a "Sports Med PA" also you are less likely to be allowed to treat interesting cases.

Try Andy Pruitt, the founder of the Boulder Center for Sports Medicine, one of the most respected sports med clinics in the country. He is also one of the nation's experts in regard to cycling injuries and custom bike fitting. The current medical director is also a PA.

 

[DrJosephKim]

I would strongly suggest that you complete med school but to keep an open mind about non-clinical careers (or at least to split your time so that you're part-time clinical and part-time non-clinical).

 

[bradt9881]

IMHO, its not worth it. To quit now, you would still have to go back and complete 24-28 months of PA school after waiting to get accepted to a slot. You would have in all likelyhood finished your MD and been picked up for residency about the same time as you would have been able to complete PA school....

 

[Dr 14220]

There are really 2 classes of pa new grads; those with prior significant experience and those without. those with experience generally can find a job they are interested in and chances are it is related to their prior job:
paramedic to pa to em pa
rt to pa to pulmonology/critical care pa
oncology rn to pa to heme/onc pa
surgical tech/rn to pa to surgical pa
ortho tech to pa to ortho pa
etc

many of those without this prior experience have to take what is left after those with experience get their pick of jobs.
the pa ownership thing is very regional. I personally know/work with several pa's in my area who own their own clinics and hired an md supervisor. very common in north carolina and washington state for example.
regarding switching specialties I agree in part. certainly em to surgery or peds to oncology, etc would be a huge leap but pretty much anything to fp is easy because
1.the primary focus of our initial training was fp and we all are required to retake our boards which focus on this every 6 yrs regardless of which specialty we go into so we have to stay up on primary care.
2. there are tons of pa jobs in fp with just under 50 %( 48% ish) of pa jobs out there in primary care at this point.

Maybe this is how things were and how they may be for the next few years for PAs. But, it seems like prior HCE is becoming less and less an emphasis for PA school admission. Thus, soon the majority of PA grads will not have any real, meaningful prior experience in health care. This may or may not be a bad thing.

Who would be the better PA.......

the 40 year old who has been a PA for 3 years after going to PA school at 35 but was a paramedic for 20 years before that...

or

the 40 year old PA who went to PA school with no experience, graduated at 22, and has been a PA for 18 years.

Im betting on option # 2.

 

[deleted6669]

Who would be the better PA.......
the 40 year old who has been a PA for 3 years after going to PA school at 35 but was a paramedic for 20 years before that...
or
the 40 year old PA who went to PA school with no experience, graduated at 22, and has been a PA for 18 years.
Im betting on option # 2.

The important question though is who would be the better/safer pa for the first 5 yrs in practice and that's PA #1.
PA #2 will have a huge learning curve the first few yrs and make more errors than PA #1.
Those errors can be significant( think md intern level errors).
that's why we should encourage the path of PA#1>PA#2.

"PA #3" used to be much more common. the 40 yr old pa who was a medic for 4-5 yrs after high school and has been a pa for 15 years.

 

[Dr 14220]

The important question though is who would be the better/safer pa for the first 5 yrs in practice and that's PA #1.
PA #2 will have a huge learning curve the first few yrs and make more errors than PA #1.
Those errors can be significant( think md intern level errors).
that's why we should encourage the path of PA#1>PA#2.

"PA #3" used to be much more common. the 40 yr old pa who was a medic for 4-5 yrs after high school and has been a pa for 15 years.

Well, Im not disagreeing with you that prior experience is preferable - as I was an EMT throughout undergrad before attending a masters PA program. However, I really dont feel like my experience as an EMT is going to matter all that much once i am practicing medicine as a PA. I think you over value the importance of prior experience because you had a ton before going to PA school. Being an EMT or paramedic is not the same as being a PA. More essential is the particular individual in question.

The fact is that PA is now becoming a first (and possibly lifelong) career for most folks, as opposed to a second one after being a medic, nurse, etc...

I dont mind that, but i think a one year internship/residency may beneficial and possibly essential for the new PA breed.

 

[deleted6669]

I think high level experience(medic/rn/rt) is of great benefit to a pa. I still get jobs in part because I used to be a 911 medic. it was a deciding factor in getting my solo coverage er job. there was no question that I knew how to intubate, run a code, start difficult lines, etc while with other applicants there was. there is still stuff I do at 3 am on auto pilot when awoken from a dead sleep that I learned as a medic that others without this experience have to think through(and often miss parts of).
6 months as an emt-basic is nice but you're right, has little bearing on long term practice patterns as a pa.
I would also be in favor of a required residency for anything except primary care.

 

[KingstonPre]

DUDE, you have the hardest yr of medschool done. stcik it out and do a cush family friendly fp residency with a night float pool then do a sports med fellowship and you are golden.
in your shoes there is no way I would drop out now.
chances are you would also have problems getting into pa school as well. requirements are different and you might even need some more prereqs. the competition now for pa school is similar to medschool with some programs having > 1000 apps for 30 seats.

^^^ what he said

Plus,
80% of those 6-7 years you're gonna spend traveling and working in the hospital having people call you Doctor anyway, only difference is the pay. You still have to take exams when you're a real doctor or PA.

PA school you'll be spending the same amount of time in a classroom setting as you would finishing up your second year and taking the Step-1 exam. You're in a rush to lose the prestige of being a doctor? I don't get it.

 

[lapelirroja]

Not really. It's like any other job. If you graduate and work in GI for four years or so and then all of a sudden you decide to go ER then you're going to have apply against others just as in any other occupation. It's like going from an account manager at company A and moving into HR in company B. It can be done, but you're going to be applying against a pool of people already working in that specialty thus less likely go get hired. I think the lateral mobility thing is too over rated.

No ****. But if you're comparing PA vs MD in mobility, it's still easier for the PA to move than the MD because you don't have to deal with the technicalities of completing another residency. Never said it was easy to do in general, but if you do some specialty specific CME and really study the medical literature it can, and HAS been done.