Opinion: Is being a physician assistant a better option?

[emilyemilyemily]

Currently i am enrolled in a Physician Assistant / Pre-Med program. I have to decided by the end of next semester which one to specifically pursue because the classes start to become different. I cannot decide which one to become. There is no doubt that I have the grades. I am a female, and I want to have a family someday, and I heard that doctor do not have a lot of free time to spend with their children. Also, there is the financial aspect of medical school. Can I have your opinion on these two medical professions? 😕

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[zma21]

Just a heads up, you're in the pre-MD forum. Expect a bias.

I think you're going to have to do some personal soul searching on this one. While being a physician may be more intrusive of your home life, many could argue that the lifestyle specialties will leave much time and energy to be spent with a family.

Good luck with your search.

 

[Osakhomen]

You can still have a family as an MD/DO. And you can always work part-time as a doctor and make as much or even more than a PA if you want to spend more time with your family.
I'd go with Doctor. My dad's a PA and I know sometime from him it's frustrating doing the same work as a doctor, but not getting paid as much.

 

[IlDestriero]

You can still have a family as an MD/DO. And you can always work part-time as a doctor and make as much or even more than a PA if you want to spend more time with your family.
I'd go with Doctor. My dad's a PA and I know sometime from him it's frustrating doing the same work as a doctor, but not getting paid as much.

You have to ask yourself if you want to be a cog in the wheel or the captain of the ship. PAs are great, I've worked with many PAs and NPs over the years, however a physician has a much greater depth of education. They use that education for difficult diagnostic situations, when care has to be escalated, etc. With great power comes great responsibility, at least that's what Uncle Ben used to say. Do you want that responsibility?
I used to work with a bunch of surgical PAs who assisted with surgery, did paperwork, etc. I would hate that job. The surgeon is the one who makes all the calls, and they just smoothed out the details.
Would you be happy with that, or do you want to be the one who make the calls? It's a decision everyone has to make for themselves. PAs will make much less than an MD. That will also be a factor for you to work out. I know a hospitalist that does quite well working only a couple 12 hour shifts a week. Probably more than a 9-5 full time PA. Some physician career paths offer a great deal of flexibility. You probably want to steer clear of surgery though.

BTW, I am aware that some systems use PAs with limited supervision, etc. I'm just making general comparisons, and not trying to start an argument.

 

[CDAstudent]

First off, you can certainly have a family and spend lots of time with them as an MD, but the timing may be different than you want. By that I mean, you probably won't be spending a lot time with your kids when you are in residency or a fellowship. You might be forced to wait.
My mom is a physician, and she was a huge presence in my life and my siblings' lives. She coached soccer teams, drove carpool, and brought cow body parts to my third grade science class. She made the choice to wait until she was getting out of residency to start a family.
There is no doubt that being a PA gives you more flexibility, but there is a big drop in responsibility in some cases. I have worked with PAs in different settings, including a rural community health center and a regional healthcare facility. In the community health center the PAs were fairly autonomous, and had their own patients in certain cases. However, in the hospital PAs were completely subordinate to the physicians, and were comparable to surgical techs.
In the end, you need to decide what you are looking for in a medical career and how that whether you're willing to sacrifice part of your family life for that ambition.

 

[Mr Hippopotamus]

You have to ask yourself if you want to be a cog in the wheel or the captain of the ship.

This.

 

[Drrrrrr. Celty]

For some people it is a better option to be a PA as opposed to a MD/DO. There are also obvious lifestyle advantages as well as liability benefits in the mix here.

 

[mipp0]

First off, you can certainly have a family and spend lots of time with them as an MD, but the timing may be different than you want. By that I mean, you probably won't be spending a lot time with your kids when you are in residency or a fellowship. You might be forced to wait.
My mom is a physician, and she was a huge presence in my life and my siblings' lives. She coached soccer teams, drove carpool, and brought cow body parts to my third grade science class. She made the choice to wait until she was getting out of residency to start a family.
There is no doubt that being a PA gives you more flexibility, but there is a big drop in responsibility in some cases. I have worked with PAs in different settings, including a rural community health center and a regional healthcare facility. In the community health center the PAs were fairly autonomous, and had their own patients in certain cases. However, in the hospital PAs were completely subordinate to the physicians, and were comparable to surgical techs.
In the end, you need to decide what you are looking for in a medical career and how that whether you're willing to sacrifice part of your family life for that ambition.

Comparing PAs to surgical techs? A bit harsh, I think, and I've worked with both...

PAs at the trauma hospital I worked in were like family physicians with the ER physician supervising their work. If they needed an MRI or cardio consult, they would speak to the ER physician about their case and transfer responsibility if needed. They even saw patients with complex lacerations, etc.

You are going to get a VERY biased perspective here on the pre-allopathic section of studentdoctor, so I would advise speaking to a PA and a physician. Although I would disagree with some of the posters and what they've shared, you WILL have to wait til after residency if you want a family or pursue a career in ER medicine or something like it to have more flexible hours.

Having spoken to a female IM physician of repute, she shared that she managed to raise a family early on because of her strong support network. She was clear she regretted missing a large chunk of her children's earlier years (residency) but overall felt she made the right choice.

If you want a family and want to have a more flexible schedule while having a strong clinical skill set, pursue PA. I think I'm a bit less biased because I was in your same shoes a couple years back; however, I am a male and don't plan on having a large family, and I am aware I may miss my child's first couple years (assuming I have a child)...

Oh, and the patients will sue the hospital or the doctor, but not you! Yay! Also, if you have an interest in humanitarian medicine or want to pursue hobbies, business, etc., PA is a great option. There are many reasons why so many PAs are happy with their quality of life and have the highest job satisfaction.

 

[Isoprop]

Since lifestyle is the only factor that you've mentioned that was important to you, I would say choose PA. Training to be a physician, you live like a student/slave for 7 years. After that, you MUST work very hard to pay off loans unless you match into a "lifestyle" specialty.

 

[JESSFALLING]

Don't forget that most reputable PA programs require between 500-3000 hours of medical career experience prior to acceptance. If you factor this in, you'll likely find that you can earn an MD/DO in the same time period.

The PA has the advantage that you will post stronger earnings much sooner, but your lifetime earning potential is capped. As an physician, you will be able to work PT and still make roughly the same as a FT PA, depending on your specialty. Additionally, you may decide to work FT again after your kids are raised and you will likely be much more satisfied with your physician salary. Don't forget to factor in the expense of raising your kids, buying a home, funding college, funding retirement, funding vacations, etc into your decision....You may really appreciate the higher earning power of an MD/DO.

Secondly, a PA is just that, an assistant. Are you comfortable entering a career where you will never be the boss? Personally, I want to own and run a small practice after residency. A PA would not allow me to achieve my goal.

Thirdly, there are fields in medicine which offer excellent ability to schedule your career around your home obligations. You can choose to work in one of these "lifestyle" fields. Psychiatry is a good example of this and it is also not an overly competitive field so you should be able to secure a residency slot in it if you desire one. You can easily work PT as a Psych attending - days, nights, or weekends. You can also fairly easily start a small practice with low overhead. If you think you would enjoy psychiatry, then you should strongly consider MD/DO. Psychiatry is also one of the less stressful residency programs to complete, from an hours-worked perspective. This, coupled with decent earning potential and flexible hours might make it the perfect fit for you.

Lastly, do you want to be a doctor? If so, don't waste your time with PA because you'll likely regret your decision down the road.

PS - don't forget to shadow both professions. It's one thing to think about all the pros and cons of each field, and another entirely to see them first hand.

 

[mipp0]

Don't forget that most reputable PA programs require between 500-3000 hours of medical career experience prior to acceptance. If you factor this in, you'll likely find that you can earn an MD/DO in the same time period.

The PA has the advantage that you will post stronger earnings much sooner, but your lifetime earning potential is capped. As an physician, you will be able to work PT and still make roughly the same as a FT PA, depending on your specialty. Additionally, you may decide to work FT again after your kids are raised and you will likely be much more satisfied with your physician salary. Don't forget to factor in the expense of raising your kids, buying a home, funding college, funding retirement, funding vacations, etc into your decision....You may really appreciate the higher earning power of an MD/DO.

Secondly, a PA is just that, an assistant. Are you comfortable entering a career where you will never be the boss? Personally, I want to own and run a small practice after residency. A PA would not allow me to achieve my goal.

Thirdly, there are fields in medicine which offer excellent ability to schedule your career around your home obligations. You can choose to work in one of these fields. Psychiatry is a good example and is not an overly competitive field so you should be able to secure a residency slot if you desire one. You can easily work PT as a Psych attending - days, nights, or weekends. You can also fairly easily start a small practice with low overhead. If you think you would enjoy psychiatry, then you should strongly consider MD/DO. Psychiatry is also one of the less stressful residency programs to complete, from an hours worked perspective. This, coupled with decent earning potential and flexible hours might make it the perfect fit for you.

Lastly, do you want to be a doctor? If so, don't waste your time with PA because you'll likely regret your decision down the road.

PS - don't forget to shadow both professions. It's one thing to think about all the pros and cons of each field, and another entirely to see them first hand.

You have to love psych to do psych. Having spoken to psychiatrists (considered child psych myself), it is NOT an easy job and you have to have a passion for it. If you do enjoy psych, then you hit the jackpot, because what JESSFALLING posted is correct.

Also, regarding the pay cap, PAs make good money and can be specialized. They also don't have to spend several years in residency if they choose to pursue another specialty, as the move is much easier than if you were a physician. Plus, if you make $80,000+ full time or let's say $60,000 part time with a flexible schedule, will you really be unhappy? The path to a PA is also not 4 years of med school + 3 - 5 years of residency...

Again, lawsuits. They mess up family life. Think about it.

 

[Isoprop]

Don't forget that most reputable PA programs require between 500-3000 hours of medical career experience prior to acceptance. If you factor this in, you'll likely find that you can earn an MD/DO in the same time period.

You can grab 1000 hours working full time as a STNA or EMT for 2 summers. Or even with the schools that require 2 years of FTE, that's an extra 2 years to a 2 year program. Even if you tack on a residency program, that's still significantly less than a FP or a general internist (7 years).

 

[bucks2010]

You have to ask yourself if you want to be a cog in the wheel or the captain of the ship.

Quoted for truth. This statement will be much more meaningful for you if you have ever worked a full-time job as a "cog". It's ok for a while, but I couldn't imagine being one for my whole career. You may be different.

 

[mipp0]

Quoted for truth. This statement will be much more meaningful for you if you have ever worked a full-time job as a "cog". It's ok for a while, but I couldn't imagine being one for my whole career. You may be different.

PAs are not mere cogs, and they have the opportunity to pursue positions of leaderships within the hospital, just like nurses.

 

[mipp0]

BTW, I am 100% dead set on pursuing my MD, but I'm just providing a more balanced perspective here, both for the OP and other readers.

 

[Omppu27]

I was in your exact spot recently. I actually thought I was set on PA because of length of schooling, ability to switch specialties, and "better hours" (something people told me but isnt always true). However, after shadowing a PA and gaining some first hand insight I realized it wasn't for me. I don't like the fact that what state I am in would affect my scope of practice, I realized that after working in one specialty for a while that you're probably not gonna mess with switching, and I wanted the chance at more control of my own hours (being your own boss). Also, as an MD, you just have many more doors open in general (ie research). I could talk about this foreverbut im writing from myphone = inconvenient.

You should definitely check out paforums. it's a great website just like this but for pa's.

Good luck! I hope it works out for you

 

[bucks2010]

PAs are not mere cogs, and they have the opportunity to pursue positions of leaderships within the hospital, just like nurses.

You are talking about the 5% that end up in some sort of leadership position. Like nurse managers as opposed to floor nurses.

I am talking about the other 95%. Let's not get caught up in arguing about the exceptions to the rule.

PA's are meant to support/extend physicians, and as such you will find that the vast majority of them work under the direction of a physician.

 

[CDAstudent]

Comparing PAs to surgical techs? A bit harsh, I think, and I've worked with both...

PAs at the trauma hospital I worked in were like family physicians with the ER physician supervising their work. If they needed an MRI or cardio consult, they would speak to the ER physician about their case and transfer responsibility if needed. They even saw patients with complex lacerations, etc.

You are going to get a VERY biased perspective here on the pre-allopathic section of studentdoctor, so I would advise speaking to a PA and a physician. Although I would disagree with some of the posters and what they've shared, you WILL have to wait til after residency if you want a family or pursue a career in ER medicine or something like it to have more flexible hours.

Having spoken to a female IM physician of repute, she shared that she managed to raise a family early on because of her strong support network. She was clear she regretted missing a large chunk of her children's earlier years (residency) but overall felt she made the right choice.

If you want a family and want to have a more flexible schedule while having a strong clinical skill set, pursue PA. I think I'm a bit less biased because I was in your same shoes a couple years back; however, I am a male and don't plan on having a large family, and I am aware I may miss my child's first couple years (assuming I have a child)...

Oh, and the patients will sue the hospital or the doctor, but not you! Yay! Also, if you have an interest in humanitarian medicine or want to pursue hobbies, business, etc., PA is a great option. There are many reasons why so many PAs are happy with their quality of life and have the highest job satisfaction.

In the hospitaI work at (smallish level II trauma center), PAs are not employed in the ER, and are used sparingly on the medical floors. They are mainly employed by private surgery practices who contract with the hospital, and strictly assist on all procedures.
My perspective, as I said, is limited by my experience. Judging from the other posts and from what I have seen, PAs can have a wide range of responsibility, depending on context.

 

[theseeker4]

PAs are not mere cogs, and they have the opportunity to pursue positions of leaderships within the hospital, just like nurses.

...I'm not sure you are making the best case for PA's being nearly equivalent to doctors when you compare them to nurses.... (nothing against nurses, but they are definitely different jobs)

 

[chrissyxf]

I'm currently a PA (female) and now am starting medical school in the fall. I can share with you my perspective from when I decided against medical school 5 years ago and why/how that perspective has changed.
Why I chose PA: all the reasons stated above which include lifestyle, less school, patient-care focused, decent pay with good hours. I wanted to be an MD for a long time but decided against it because I wanted a family and didn't want to put in 7 more years of school/residency (minimum). I work on a busy inpatient service with no weekends or call because we have fellows. I first assist in surgical procedures and perform my own procedures as well (paracentesis, suturing, basic stuff). I round with an attending MD for an hour a day but most of the time clinical decisions are mine to make. Sounds great right?
It is. But what has changed is this: I discovered that I actually really like research (you can't be a PI as a PA, although you can author papers and do research) and I like teaching (you make very little in academic medicine as it is, let alone as a PA, unless you do administration, which I don't want to do). I also hate HATE that I have little background on the underlying pathophysiology of what's going on with my patients or why we treat them a certain way. PAs are taught algorithms and they work well- right up until they don't because the patient doesn't read the textbook. I do alot of academic reading on my own with regular reviews of journals and attending conferences but I want more than that.
Bottomline: I still think that being a PA is a great thing for the right person who is looking for decent money/benefits with less commitment. But if you look deep inside, and you want to be a doctor, it will never NEVER go away. I thought it would when I realized the benefits of being a PA but it hasn't and it will nag you and you'll end up going back. This is something I've heard from other PA-MD colleagues as well. I have a mentor who is a single mom and is doing well with it- yes, she's missed out on some things but she and her daughter have a great relationship and her daughter is turning into a great young woman. It is possible, although not easy. You have to really want it.
Good luck with your decision. I've been there and know how hard it is- feel free to PM me.

 

[mipp0]

...I'm not sure you are making the best case for PA's being nearly equivalent to doctors when you compare them to nurses.... (nothing against nurses, but they are definitely different jobs)

I wasn't trying to argue that PAs are equivalent to physicians. Having worked with hospital leadership, I was making it clear that PAs aren't mere "cogs" but can take on positions of leadership like nurses (CNO). 5% or not, the opportunities are there.

 

[mipp0]

I'm currently a PA (female) and now am starting medical school in the fall. I can share with you my perspective from when I decided against medical school 5 years ago and why/how that perspective has changed.
Why I chose PA: all the reasons stated above which include lifestyle, less school, patient-care focused, decent pay with good hours. I wanted to be an MD for a long time but decided against it because I wanted a family and didn't want to put in 7 more years of school/residency (minimum). I work on a busy inpatient service with no weekends or call because we have fellows. I first assist in surgical procedures and perform my own procedures as well (paracentesis, suturing, basic stuff). I round with an attending MD for an hour a day but most of the time clinical decisions are mine to make. Sounds great right?
It is. But what has changed is this: I discovered that I actually really like research (you can't be a PI as a PA, although you can author papers and do research) and I like teaching (you make very little in academic medicine as it is, let alone as a PA, unless you do administration, which I don't want to do). I also hate HATE that I have little background on the underlying pathophysiology of what's going on with my patients or why we treat them a certain way. PAs are taught algorithms and they work well- right up until they don't because the patient doesn't read the textbook. I do alot of academic reading on my own with regular reviews of journals and attending conferences but I want more than that.
Bottomline: I still think that being a PA is a great thing for the right person who is looking for decent money/benefits with less commitment. But if you look deep inside, and you want to be a doctor, it will never NEVER go away. I thought it would when I realized the benefits of being a PA but it hasn't and it will nag you and you'll end up going back. This is something I've heard from other PA-MD colleagues as well. I have a mentor who is a single mom and is doing well with it- yes, she's missed out on some things but she and her daughter have a great relationship and her daughter is turning into a great young woman. It is possible, although not easy. You have to really want it.
Good luck with your decision. I've been there and know how hard it is- feel free to PM me.

Thank you for sharing this. I'm glad what the PAs told me and what you are saying overlap perfectly. Like you, I have an interest in academic medicine, and the reasons you stated are why I decided to go pursue an MD.

 

[estradiol9]

I was considering PA at one point. As a female, I would like to have a family one day also. Preferably on the larger side. I don't want to wait until I'm 30+ to start having kids. I don't want to be the absentee parent either who is immersed in her career. Those reasons pushed me toward PA very strongly. If I decided to go the PA route, I would have been done with school by age 26. I also would have much less student loan debt.. But I think in the back of my mind I would have always regretted not becoming a physician.

After thinking about it and talking to others about it, I decided I could never go through with PA. Even before applying to PA school I was already looking for doctorate degree options for PAs. I spoke to way too many older PAs who told me about how they have had patients doubt them and physicians fresh from medical school much younger than them who earned more respect. From the feedback I heard, it seems that PAs are happy in their position for some 10-15 years and then they hit the glass ceiling and there just isn't anywhere else to go.

I think it's a personal preference and you really have to listen to what your heart wants. There are many advantages to being a PA. They don't work as much. They can switch specialties more easily. It's not as competitive to get into a PA program. You come out with less debt. You start working much sooner. The salary is enough to make a comfortable living. The job outlook is good. But there are downsides as well.. Many people are ignorant about what a PA even is. You may not get the respect you deserve. You won't make nearly as much as a physician. You will never be a physician unless you decide to go to medical school. All of the PAs I shadowed didn't even have their own offices. Some of these things may sound insignificant but the question is if it will bother you later down the road. Call me superficial but I would like to be called "doctor" one day, have my own office, not have to explain what my position is and what it allows me to do over and over again to my patients.

 

[jdok]

I wasn't trying to argue that PAs are equivalent to physicians. Having worked with hospital leadership, I was making it clear that PAs aren't mere "cogs" but can take on positions of leadership like nurses (CNO). 5% or not, the opportunities are there.

Using that logic, we should tell the OP that he can become a dermatologist or rad oncologist and not worry about the hours/family life due to a kush job and residency. Even though that's 5% of physician jobs, the opportunities are there.

ucwatididthar?

Let's be honest. You really think you can give more insight to the positives of being a PA when in reality you have no experience other than hearing things through the grapevine? Stop acting like you use to be a PA or have any kind of connection with being a PA and playing a lackluster devil's advocate.

Pls go.

 

[mipp0]

Using that logic, we should tell the OP that he can become a dermatologist or rad oncologist and not worry about the hours/family life due to a kush job and residency. Even though that's 5% of physician jobs, the opportunities are there.

ucwatididthar?

Let's be honest. You really think you can give more insight to the positives of being a PA when in reality you have no experience other than hearing things through the grapevine? Stop acting like you use to be a PA or have any kind of connection with being a PA and playing a lackluster devil's advocate.

Pls go.

Through a grape vine? LOL. I spoke to 7 PAs and WORKED with them directly, not merely speaking with them. Don't group me up with you. I have over 2,000 hours of clinical experience and was half way down the PA road.

Let's be honest. You're sad

 

[maybemed2013]

Go MD, work alot and live like a pauper so that you can buy off your debts and save money for the future and then when you are ready to have kids you can work part time.
That is my plan and if your lucky marry rich....money last longer than love sad but true.

 

[Beandog]

You have to ask yourself if you want to be a cog in the wheel or the captain of the ship.

generally speaking, but many docs are also simply cogs in wheels of large organizations, or ERs. It comes down also to personality, employment choices, and fate, to some regard.
Overall though, I get your drift. The question the OP is asking is too broad for a simple answer.

I'd not want to be a PA because I know myself, and that when I ended up at the top of my career still looking upward and nowhere to go, I'd be more than a little upset.

 

[anbuitachi]

do nursing

 

[jdok]

Through a grape vine? LOL. I spoke to 7 PAs and WORKED with them directly, not merely speaking with them. Don't group me up with you. I have over 2,000 hours of clinical experience and was half way down the PA road.

Let's be honest. You're sad

Wow you spoke to 7 PAs???!!? Seven?? omg and you have 2000hrs of clinical experience? You're right...just like you're half way down the MD road...when really, you've only just begun.

Pls go.

generally speaking, but many docs are also simply cogs in wheels of large organizations, or ERs. It comes down also to personality, employment choices, and fate, to some regard.
Overall though, I get your drift. The question the OP is asking is too broad for a simple answer.

I'd not want to be a PA because I know myself, and that when I ended up at the top of my career still looking upward and nowhere to go, I'd be more than a little upset.

Hrmmm....I guess everyone other than the CEO is a cog in the "wheels of large organizations," right? If you're going to say a doctor is simply a cog in specific ERs, then imagine what a PA will be in those same ERs...

Personally I would never settle for being a PA or a nurse. The mindset that I have wouldn't allow it.

 

[postbacpremed87]

If you want to have free time to spend time with your children, then you will make time.

Currently i am enrolled in a Physician Assistant / Pre-Med program. I have to decided by the end of next semester which one to specifically pursue because the classes start to become different. I cannot decide which one to become. There is no doubt that I have the grades. I am a female, and I want to have a family someday, and I heard that doctor do not have a lot of free time to spend with their children. Also, there is the financial aspect of medical school. Can I have your opinion on these two medical professions? 😕

 

[Drogo]

Currently i am enrolled in a Physician Assistant / Pre-Med program. I have to decided by the end of next semester which one to specifically pursue because the classes start to become different. I cannot decide which one to become. There is no doubt that I have the grades. I am a female, and I want to have a family someday, and I heard that doctor do not have a lot of free time to spend with their children. Also, there is the financial aspect of medical school. Can I have your opinion on these two medical professions? 😕

This is a very tough topic to get opinions on, especially being that you're on a pre-allopathic forum and there will be a bit of bias here or there. You have to really reach deep and ask yourself 'In x amount of years will I be fine with just be being a physician assistant?". If a part of you feels that you won't be ok with that, even if only a small part, I'd say go the MD/DO route. Also on the 'I heard doctors do not have a lot of free time' subject, there is too many variables involved; the person in question, the residency matched into, time-management skills and so on.

Anyways, good luck. It's something I've been pondering as of great lately. I'm a firm believer if I don't give the MD/DO route at least one good shot, that as a PA I would be left pondering a lot of 'what if's' daily. I desperately want to avoid getting into a career that is not suffice as far as the challenge, leadership opportunities, and satisfaction I'm looking for.

 

[Mountaineer12]

I was in a similar situation this summer, I got into a pathologists assistant program, but eventually realized I wouldn't be happy doing similar things and always being limited for the rest of my life. Assistant jobs are great for free time, but there are a lot more options for lifestyle specialities that you think. It will be tough, but to me it's worth it, ask yourself if it's worth it to you too.

Also, don't worry too much about the financial burden, PA school is expensive too and as a doctor you will have the resources to pay it back. Pick what makes you happy, don't worry too much about the money, yet.

 

[MilkmanAl]

If you want to have free time to spend time with your children, then you will make time.

It's not that easy. When you're obligated to work 14 hours a day, as you often will be during your clinical years and residency or possibly before tests during M1 and M2, you're probably not going to be too hot on playing with the kids (or doing anything other than sleeping) when you get home. Med school and residency are constant struggles for people with families. You often don't have the option to "make time."

OP, if you think you're interested in primary care of some kind, I'd go the PA route o The lifestyle is so, so much better than what medicine has to offer, and the training is much shorter. Otherwise, you're likely heading for a specialty that won't allow for the life you're wanting. You could do anesthesia, I suppose, but you'd probably be better served with an AA or CRNA program.

 

[45408]

You have to ask yourself if you want to be a cog in the wheel or the captain of the ship. PAs are great, I've worked with many PAs and NPs over the years, however a physician has a much greater depth of education. They use that education for difficult diagnostic situations, when care has to be escalated, etc. With great power comes great responsibility, at least that's what Uncle Ben used to say. Do you want that responsibility?
I used to work with a bunch of surgical PAs who assisted with surgery, did paperwork, etc. I would hate that job. The surgeon is the one who makes all the calls, and they just smoothed out the details.
Would you be happy with that, or do you want to be the one who make the calls? It's a decision everyone has to make for themselves. PAs will make much less than an MD. That will also be a factor for you to work out. I know a hospitalist that does quite well working only a couple 12 hour shifts a week. Probably more than a 9-5 full time PA. Some physician career paths offer a great deal of flexibility. You probably want to steer clear of surgery though.

BTW, I am aware that some systems use PAs with limited supervision, etc. I'm just making general comparisons, and not trying to start an argument.

Agreed. In addition though, the captain goes down with the ship 😉

If something bad happens with a patient, a physician is typically going to be the one ultimately responsible, and they carry the weight and responsibility of that.

My personal opinion is that if you think you could be happy as a PA, you're looking for a more flexible job (ability to change specialties), and you want a family, then go that route. If you would be unhappy as a PA, then don't do that just because of the above reasons. I think being a PA is a very underrated option, but I would not want to be the cog in the machine. I really like the decision-making options and significantly higher level of training/education involved with being a physician. However, I have the benefit of a wife who has been very supportive all along and is doing the majority of the child-rearing.

 

[45408]

generally speaking, but many docs are also simply cogs in wheels of large organizations, or ERs.

Sure, but in the patient's care, they are the captain of that ship.

If you want to have free time to spend time with your children, then you will make time.

This is pretty naive and overly optimistic. I haven't seen my son on any Thanksgiving yet (he's 2), and I didn't see him or my wife at all last Christmas.

You can't get blood from a turnip.

 

[yoshiipa]

The salary of the a PA is relatively high compared to other health profession, however you will always need to be supervised by a doctor, so you can't really become an entrepreneur.

 

[AntiHouseMD]

Quick question: is it better to go for a PA than an MD if you want to go into primary care (pediatrics, to be exact)? I know that an MD provides more opportunities for things such as research and administration, but it seems that most primary care doctors have a difficult time making up for med school debt, especially given recent Medicare reform attempts. I know that both jobs are difficult and that MilkmanAI said PA is a better route, but what would you guys say to someone who wants to go into general peds?

 

[thesauce]

PAs are not mere cogs, and they have the opportunity to pursue positions of leaderships within the hospital, just like nurses.

Hospital admins have the least power of all. They have to work their tails off to keep the staff and patients happy. Don't go thinking they boss around physicians. The docs can just up and leave to the multitude of other job offers they have and are often very difficult (and expensive) to replace.

 

[45408]

Quick question: is it better to go for a PA than an MD if you want to go into primary care (pediatrics, to be exact)? I know that an MD provides more opportunities for things such as research and administration, but it seems that most primary care doctors have a difficult time making up for med school debt, especially given recent Medicare reform attempts. I know that both jobs are difficult and that MilkmanAI said PA is a better route, but what would you guys say to someone who wants to go into general peds?

I'd say to become a pediatrician and go to the cheapest school you can. Pediatrics residencies are not competitive, so you can go to any school you want and still match into peds, no question. I'm not saying you don't have to study and do as well as you can, but it certainly doesn't depend on your school's prestige.

It's the shortest residency out there (tied with EM and IM), so you could be done by age 29. Not too shabby.

 

[katiemaude]

I struggled a lot with this question myself and I'm glad I took an extra year to explore my options before applying. I did all the premed prereqs plus a few that local PA schools require, shadowed PAs, MDs and DOs for a combined 150 hours, volunteered 250 hours in an emergency department to get clinical experience, then studied for the MCAT. A lot for me was going to depend on getting a decent MCAT score and I think I achieved that. I could have applied somewhat late this past season but decided for a lot of reasons to wait til this spring. In the mean time, I got a job working full time as a nursing support tech which would have given me all the hours I needed to apply for a PA program, but most importantly it's given me access to a lot of doctors and PAs.

From where I stand right now, the surgery PAs do amazing things, but I could see how some people would feel trapped in that role after doing it for many years. On the plus side, you have the benefit of working in surgery without the long residency, a reasonable ability to switch among other surgical specialties if you want something different eventually, and the majority of the patient contact. I have met PAs who work for the hospital and are on shifts and are done when their shifts are over and they are relieved by another PA, and PAs who work for a surgeon and are there til the bitter end so that depends on the position you take. On the negative side for many PA positions, there is the "not being the captain" aspect, the lower pay, the administrative/drudge work. I have not spoken to any PAs in primary care but the primary care physicians I've shadowed have all said that their field is moving towards using mostly PAs and that compensation-vs-debt-wise, I would be in a better financial position as a primary care PA than a primary care MD.

I am 34, single and childless, so the amount of schooling taking away from my family only matters in a hypothetical sense. I have no guarantee of meeting someone I'd want to have kids with on either path, so I decided a long time ago that it's not going to be a factor in my decision at this point. If I find myself in the position of wanting kids with a partner in 4-5 years, I can only hope we will find a way to make it work. If I'm still single and wanting kids after residency, I'll look into adoption.

So that's my viewpoint. The best thing you can do is shadow PAs and physicians/surgeons and talk to as many as you can about their jobs while covering your bases with prereqs (e.g. take organic II if you think there is a chance you want to apply MD or DO) and getting hands-on patient care experience, because that will help you either way.

 

[NatalieA1986]

I never considered medical school because I didn't want to give up that much of my life, period. A salary cap or limited scope of practice isn't a big deal to me. I can be a midlevel and make 80-120k and be happy. If I wanted to do medical procedures that are outside of a PA's scope of practice it might be different for me. I would hate to choose a specialty because of the lifestyle, rather than it being something I wanted to do. As a midlevel, you can have a good lifestyle no matter what specialty you choose. I have shadowed several cardiology midlevels and they work four 10 hour days per week, unlike their physician colleagues.

I was recently accepted to PA and NP programs. In the end, I felt too limited by the career advancement/leadership positions available to PAs. As a NP, I can have the scope of practice I want and potential to take on leadership roles in nursing with predefined paths.

Just my two cents. It's all about your values. I don't ever want kids. I want my life, and I want it now. Being a midlevel isn't for everyone, and neither is medical school/ being a physician.

 

[icebreaker71]

This thread is pretty old now, but for anyone who found this from a google search like I did, I'll go ahead and say my opinion.

Like many people have said, it's really about what you want. Some people have to be on top, and they ruin themselves trying to get to the "best" thing. My philosophy is that I know myself, I know what I want, and I know that I will love the career of PA and everything that it offers within its scope of practice. I am happy to consult with those "above" me. Medical doctors sacrifice a lot to be where they are at, and I respect their status.
Personally, primary care is just my personality. I'm not looking for super complex diseases to figure out. I don't want to be House. Of course, I want to be important and feel needed, but I don't need to be a legend. And not wanting to be at the top of the chain doesn't make me a nobody, it just means that I know what I want to give in the field of medicine.
It really bugs me when people obsess with the hierarchy of things. Just pick the career that is the best fit for you. NOT the career that is the "best". If not pursuing medical school will bug you that much, then go for it! I really don't mean this in a negative way, but if you can't help but regret not going to med school then you deserve to suffer through it and truly see for yourself.

I've heard that many doctors regret GOING to med school, and I've heard that many PA's regret NOT GOING to med school.

Just think about that.

It's your decision.