P.A or M.D dilemma :-/

[AvarageJay]

hi im newbie to this site..... so please remind me if im violating in any way... thanks....

well right now in my first year of pre-med work..... keeping my grades up in what not...... but im in a little bit of dilemma..... which is going the P.A route or the M.D route.....

ive been doing a whole lot of research these past several months and i still cant seem to figure what should be my drive.....i have people tell me "hey, go for M.D you might as well it'll be better for you in the long run" and then others say "be a P.A if you just cant do 10+ yrs of school..."

i want to be able to help people, to make sure people are healthy, and at the same time be able to practice medicine without restraint.....

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[Farmer Jane]

hi im newbie to this site..... so please remind me if im violating in any way... thanks....

well right now in my first year of pre-med work..... keeping my grades up in what not...... but im in a little bit of dilemma..... which is going the P.A route or the M.D route.....

ive been doing a whole lot of research these past several months and i still cant seem to figure what should be my drive.....i have people tell me "hey, go for M.D you might as well it'll be better for you in the long run" and then others say "be a P.A if you just cant do 10+ yrs of school..."

i want to be able to help people, to make sure people are healthy, and at the same time be able to practice medicine without restraint.....

Look at yourself 20 years from now. What will you wish you had done?

 

[chimichanga]

Look at yourself 20 years from now. What will you wish you had done?

I wish I'd been a backhoe operator, in the middle of nowhere, digging an endless hole, belonging to the backhoe union...

 

[deleted6669]

without restraint=md.
of course there is always hospital restraint of trade, insurance, etc but these are all more minor issues for an md/do than a pa.
go md.
the typical premed student is ill prepared for pa school. the focus is different.
good pa schools want individuals with prior life and medical experience not 22 yr old 4.0 study machines with minimal life experience outside of school(the ideal med student).

this is the class profile for the class at ohsu's pa program last yr:

The following profile represents the class accepted for the 2007-2008 school year in the entry level p.a. program:
Total applications received: 537
Total applicants interviewed: 120
Total accepted: 36 ( 6.7% of total applicants)
Female to male ratio: 23 female/ 13 male
Average age: 30.1; range: 23-48
Average GPA: 3.48
Average natural science GPA: 3.41
Average GRE Scores: Verbal 550; Quant 638; Analytical Writing 4.6
In-state vs. Out-of-state ratio: 17 In-state/ 19 Out-of-state
Average years of health care experience: 2.5 years
Types of health care experience: Medical technologist, medical assistant, EMT/paramedic, peace corps volunteer, lab assistant/ phlebotomist, health care-related technicians, clinical research assistant, community health worker, CNA, physical therapy aide.

 

[Farmer Jane]

I wish I'd been a backhoe operator, in the middle of nowhere, digging an endless hole, belonging to the backhoe union...

You too?

(What I really want to do is farm--I'm in nursing so I have enough money to do what I love. )

 

[AvarageJay]

without restraint=md.
the typical premed student is ill prepared for pa school. the focus is different.
good pa schools want individuals with prior life and medical experience not 22 yr old 4.0 study machines with minimal life experience outside of school(the ideal med student).


so basically to ba a P.A, it is a MUST to have prior health care related experience? i see that you were a EMT for quite some tie in your life, what made you want to go P.A?
would you think it would be a good idea if i decide to study and work in a medical tech lab fo a couple yrs and then go to P.A school ( i would be in my thirties by that time)....
if you look at it it is the same time doing both except by that time , your still a P.A.....

 

[deleted6669]

the majority of pa programs want prior paid medical experience. some of the newer ms level programs will accept volunteering.
this is frequently discussed at length as the pa forum at www.physicianassistant.net
you might want to check that out.
as far as me, pa was the next logical step after medic. I became a paramedic to get the experience needed to be an em pa. I started my life in em as an emt-basic in high school and worked as an er tech for 5 yrs with a great group of pa's. I worked 24 hrs/week during college and full time summers + through medic school as a tech. the pa's I worked with encouraged me to get further medical training beyond emt-basic in order to be appropriately prepared for pa school. I worked as a medic for 5 years before becoming a pa. my entire undergrad college preparation was aimed at acceptance to 1 of 2 pa programs that interested me. there were a lot fewer then, around 50, compared to the 140 today.
I had a lot of courses needed specifically for pa school and didn't take several needed for med school as the prereqs were very different then. they are a lot more similar now.
later as a pa I was thinking about going back to medschool and took the prereqs I lacked. when I did the math though becoming an md at that point didn't make financial sense as I would lose 7 yrs of pa level income in addition to getting hundreds of thousands of dollars in debt, a negative income flow of over 1 million dollars. my financial break even point for pa vs md was around the time most folks retire. so I remain a pa.

 

[deleted6669]

I'll never quite understand these threads. Basically people say, "I have two career choices in mind, both seem appealing, however one requires 3-4x more time in training, much greater work hours, endless personal and professional abuse, and constant fear of litigation throughout your entire life."

Listen, to restate the obvious, if you have to pick between being a physician and being something else, then be something else, because it's just not worth it.

how is 11 yrs 3-4 x a min of 6? it's not even double....
medschool 4+4+ 3(or more)
pa school 4+2(not including prior medical training of 1-2 yrs).
I have 9 yrs of post high school education(bs#1, medic school, bs#2, ms, post ms adv. cert).....and work more hrs than the physicians in my group by almost 2X(they are full time at 96 hrs/mo: 12 eight hr shifts....I work 18-19 tens....who has more free time ....)

 

[AvarageJay]

I'll never quite understand these threads. Basically people say, "I have two career choices in mind, both seem appealing, however one requires 3-4x more time in training, much greater work hours, endless personal and professional abuse, and constant fear of litigation throughout your entire life."

Listen, to restate the obvious, if you have to pick between being a physician and being something else, then be something else, because it's just not worth it.

so your saying being a M.D is not worth it?

 

[Farmer Jane]

I'm saying that, in my limited experience with people both in and out of medicine, if you have to ask, it probably won't be worth it to you.

I agree.

 

[primadonna22274]

You will never be able to practice medicine without restraint as a PA.
You may have a fair degree of autonomy, broad scope of practice, or you might be pigeonholed. Depends on a lot of factors--state practice laws, individual employer, your own experience and comfort zone to mention a few. Now, for that matter, "without restraint" as a physician is an uphill battle too given the third-party payors practicing medicine without a license....
Good luck, Lisa PA-C

hi im newbie to this site..... so please remind me if im violating in any way... thanks....

well right now in my first year of pre-med work..... keeping my grades up in what not...... but im in a little bit of dilemma..... which is going the P.A route or the M.D route.....

ive been doing a whole lot of research these past several months and i still cant seem to figure what should be my drive.....i have people tell me "hey, go for M.D you might as well it'll be better for you in the long run" and then others say "be a P.A if you just cant do 10+ yrs of school..."

i want to be able to help people, to make sure people are healthy, and at the same time be able to practice medicine without restraint.....

 

[deleted6669]

My calculation didn't include undergrad, which is just a given. And the healthcare experience requirement that you decided to rename "prior medical training" can hardly be considered as part of a PA's or MD's training.

PA = 2y school, optional 1y post-graduate training
MD = 4y school, 3-7y residency (specialty dependent)
Ratio ranges from 2x-5x depending on which end of the spectrum you pick.

Also, the docs in your group that work 96hrs/mo (ie - 25hrs per week) are hardly the norm or anywhere near the average for most physicians. The majority of physicians don't do shift work. Even with your 50hrs/wk, you're still not at the average for most physician specialties.

fair enough...
fwiw the em doc in our group who does the most(of 30 docs) does 16 shifts=108 hrs/mo.
at our affiliated urgent care ctr the fp docs do 16 nine hr shifts/mo for 144 hrs/mo.
all the em pa's do at least 15(150 hrs) and the guy who does the most does 22(220 hrs).
more and more docs are going to shift work, although it's certainly not the norm at this point. em/urgent care, hospitalists, trauma/critical care, anesthesia, and radiology are all groups at my facility who work shifts with some docs working as little as 60 hrs/mo(moms) up to 240 hrs/mo or so(intensivists).
surgeons of course work fairly unpleasant hrs across the board....but so do their pa's.....lots of surgical pa jobs are 80 hrs/week...lot of burnout there of course but great money, although at an 80 hr week it should be good money, you're working the equivalent of 2 full time jobs for nl folks.....
back to the original question-if you have a passion to practice medicine and/or you need to be the ultimate boss go md. if you might be ok with being less than the boss or fighting an uphill battle for autonomy then pa might be ok for you. I have changed jobs 4 times and relocated over 1000 miles in an effort to increase my scope of practice and improve my autonomy. if I was a doc I would probably still be at job #1 as there are very few restrictions anywhere on em md scope of practice-no one is going to tell an em doc that he/she can't do an lp, reduce a shoulder dislocation, start a central line, run a code, evaluate elderly chest pain, run traumas, etc.... all things I have had to work hard to be granted priviledges for..

 

[primadonna22274]

Gee, I routinely did 15-16 12hr/ mo until I got burned out in the ED last month. I've only worked an average of 36 hr/wk this month and I don't know what to do with all my time off. Unfortunately it's gonna hit me in the pocketbook. Ugh.

 

[deleted6669]

Gee, I routinely did 15-16 12hr/ mo until I got burned out in the ED last month. I've only worked an average of 36 hr/wk this month and I don't know what to do with all my time off. Unfortunately it's gonna hit me in the pocketbook. Ugh.

my group is composed mostly of older pa's with a few youngins.
I think the age range is 32-60 with an avg close to 50. avg experience as an empa is probably 12-15 yrs with a range of 5-35.
around 50 folks like to work less and do fewer nights for some reason.....

 

[primadonna22274]

Aw E, I'm not that much younger than you...3 weeks to 34....

my group is composed mostly of older pa's with a few youngins.
I think the age range is 32-60 with an avg close to 50. avg experience as an empa is probably 12-15 yrs with a range of 5-35.
around 50 folks like to work less and do fewer nights for some reason.....

 

[silas2642]

I'll never quite understand these threads. Basically people say, "I have two career choices in mind, both seem appealing, however one requires 3-4x more time in training, much greater work hours, endless personal and professional abuse, and constant fear of litigation throughout your entire life."

Listen, to restate the obvious, if you have to pick between being a physician and being something else, then be something else, because it's just not worth it.

I'm just a lowly med student, but I definitely have to agree. It's just not worth going into medicine unless there is absolutely, positively nothing else that you can picture yourself doing. If you can envision yourself doing anything else with your life, GO FOR IT, because this is a really flipping hard path. I don't know if you think you're working hard now, but you're not. Med school dumps infinitely more work on you, you have to worry about matching into the specialty of your choice in the area of your choice, and as the years of med school go by there is just more work (with the exception of fourth year). Residency just gets worse. And then when you become an attending, you get hit with more crap-- hospital administrators, PA's, NP's, DNP's, nurses, respiratory therapists, PT's, OT's, CRNA's, PCA's, CNA's, LPN's, APRN's, CRN's, social workers, cafeteria workers, janitors, transporters, and candy stripers all tell you that you're wrong and that they know more than you because they read something online that contradicts your differential or your treatment (this is just what I've observed and heard from many other doctors-- I'm hoping it's not THAT true).

 

[AvarageJay]

I'm just a lowly med student, but I definitely have to agree. It's just not worth going into medicine unless there is absolutely, positively nothing else that you can picture yourself doing. If you can envision yourself doing anything else with your life, GO FOR IT, because this is a really flipping hard path. I don't know if you think you're working hard now, but you're not. Med school dumps infinitely more work on you, you have to worry about matching into the specialty of your choice in the area of your choice, and as the years of med school go by there is just more work (with the exception of fourth year). Residency just gets worse. And then when you become an attending, you get hit with more crap-- hospital administrators, PA's, NP's, DNP's, nurses, respiratory therapists, PT's, OT's, CRNA's, PCA's, CNA's, LPN's, APRN's, CRN's, social workers, cafeteria workers, janitors, transporters, and candy stripers all tell you that you're wrong and that they know more than you because they read something online that contradicts your differential or your treatment (this is just what I've observed and heard from many other doctors-- I'm hoping it's not THAT true).

i envision myself practicing medicine...... thats all i want to do.... thats why im in pre-med.......ive also been to my local hospitals a few times.... seen docs, P.As, nurses, med techs, all work happily together..... in my neighborhood there is alot of doctors and i ask them this.... i would say 70% of the M.Ds i spoke with told me to try being a P.A..... ether or M.D or P.A you're going to be practing medicine.... but responsibilities are diff...

 

[silas2642]

i envision myself practicing medicine...... thats all i want to do.... thats why im in pre-med.......ive also been to my local hospitals a few times.... seen docs, P.As, nurses, med techs, all work happily together..... in my neighborhood there is alot of doctors and i ask them this.... i would say 70% of the M.Ds i spoke with told me to try being a P.A..... ether or M.D or P.A you're going to be practing medicine.... but responsibilities are diff...

I've worked with PA's and MD's and I would definitely say that the responsibilities are different; MD's/DO's have a lot more training and with that comes more freedom and responsibility. Again, I'm just a lowly med student, but it seems that as an attending physician, you're the leader of the team and the buck stops with you. When the crap hits the fan, it hits your face. Becoming a doctor is also a lot of work and sacrifice, and it's not as glamorous as people think it is.

I guess I'll just reiterate my last statement-- if you can envision yourself being satisfied as a PA, then go for the PA degree. Probably the best thing you can do for yourself right now is to talk with some PA's, shadow one or two for a while, and shadow a physician. Research it, and then make your decision based on what you've seen with your own eyes and what you know about yourself rather than a bunch of anonymous people on the internet who are trying like crazy to avoid studying for an anatomy exam that they have in, oh, 3.5 hours. By doing this, then you will know for certain whether or not medicine is the right path for you, and you won't be posting on the allopathic/osteopathic forum in 3 years screaming, "what in God's name have I done-- I need to get out of medicine but I'm too far in debt!" Good luck with your decision.

 

[AvarageJay]

without restraint=md.
of course there is always hospital restraint of trade, insurance, etc but these are all more minor issues for an md/do than a pa.
go md.
the typical premed student is ill prepared for pa school. the focus is different.
good pa schools want individuals with prior life and medical experience not 22 yr old 4.0 study machines with minimal life experience outside of school(the ideal med student).

this is the class profile for the class at ohsu's pa program last yr:

The following profile represents the class accepted for the 2007-2008 school year in the entry level p.a. program:
Total applications received: 537
Total applicants interviewed: 120
Total accepted: 36 ( 6.7% of total applicants)
Female to male ratio: 23 female/ 13 male
Average age: 30.1; range: 23-48
Average GPA: 3.48
Average natural science GPA: 3.41
Average GRE Scores: Verbal 550; Quant 638; Analytical Writing 4.6
In-state vs. Out-of-state ratio: 17 In-state/ 19 Out-of-state
Average years of health care experience: 2.5 years
Types of health care experience: Medical technologist, medical assistant, EMT/paramedic, peace corps volunteer, lab assistant/ phlebotomist, health care-related technicians, clinical research assistant, community health worker, CNA, physical therapy aide.

hey emedpa i got a question for you..... instead of going to another health care career.... would if i go keep up with my pre-med,...... go to P.A school, and then do a P.A residency... would that work?

 

[primadonna22274]

I suggest you work on your spelling and grammar first.
Ok, snarkiness over.
PA residencies are a good way to go for someone with very little healthcare experience (assuming you get into a PA program with little or no HCE) and for the PA who wants advanced clinical instruction in a specialty of choice.
They are not required and for the most part will not make you more money, but it does provide you with a skill set and some with a master's degree if you don't earn a master's in PA school.

hey emedpa i got a question for you..... instead of going to another health care career.... would if i go keep up with my pre-med,...... go to P.A school, and then do a P.A residency... would that work?

 

[deleted6669]

Aw E, I'm not that much younger than you...3 weeks to 34....

sent you a pm

 

[Chronic Student]

It's true.

Even worse is when they pull the, "I've been a ______ for 5 years, so if you're not doing things the way I've always seen them done in the past, you must be an idiot."

I'm in the ICU right now. The RTs keep changing my vent settings without asking. It's getting annoying.

I feel ya.

The internal medicine residents keep going behind me and changing my orders to have our patient who is s/p evacuation of a SDH lay flat and are sitting him up at 45 degrees.

I don't think they get that not every neuro patient has increased ICP and that maybe the reason I want him to lay flat is so that his drains can...well, drain.

This time when I wrote the order I specifically stated that any changes to his positioning have to be cleared through the neurosurgeon first.

BTW, I have tried to explain it to them on four different occasions, but I'm just the dumb PA.

 

[hotinwoof]

That is a tough choice. It also depends on what kind of money you want to make and where you want to practice. My friends uncle is an oncologist with 3 clinics. His 3 docs left him and now he does everything by himself and with 2 PAs. The 2 PAs seem happy enough. Beats me what they get paid. I know the MDs were paid 300k to start.

Medicine isnt so bad. My sister is an internist, bro is a pain doc, and another in law who is ER and another who is also internist. Have best friend who is cardio. They like medicine.

 

[deleted6669]

That is a tough choice. It also depends on what kind of money you want to make and where you want to practice. My friends uncle is an oncologist with 3 clinics. His 3 docs left him and now he does everything by himself and with 2 PAs. The 2 PAs seem happy enough. Beats me what they get paid. I know the MDs were paid 300k to start.

Medicine isnt so bad. My sister is an internist, bro is a pain doc, and another in law who is ER and another who is also internist. Have best friend who is cardio. They like medicine.

the pa's probably make 90-110k/each or so. basically 3 pa's for the price of 1 md oncologist. quite a deal for your friend's uncle. they probably bill 500k/yr each so the guy is pocketing the difference or rolling it back into the practice.

 

[TexPre-Med]

As the P.A. degree is more and more recognized, the average age is getting much younger. In TX, the average age is probably around 26. I've seen plenty of really young P.A. students. The degree is getting so popular that people right out of college with lots of healthcare community service are getting in just fine.