PA-C, but always wanted MD

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Harnandey0929

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I realize I'm posting this in the pre-med forum. I'm not sure where all the other PA to MD posts ended up, so I just figured it fit best here.

I'm 27, married, with two beautiful little girls (with hopes for 1-2 more kiddos), and have been working as a PA in hospitalist medicine for 3 years now. I'm about 30K away from paying off my student loans (woo!) and make about $120K a year. A pretty good gig I'd say!

Yet, I sometimes feel like I should've fulfilled my lifelong dream and went to med school.

Being a physician was what I wanted to do since the 3rd grade. I changed my mind late in my junior year of college right after meeting my husband (who was also pre-med). We both decided to change our career goals and we went to PA school together after realizing we wanted a big family and wanted more family and home time together. I was so close to applying that I had even taken the MCAT, and I think I did quite well, scoring a 34 with a 3.9 GPA (before the MCAT change of course).

I'm satisfied as a PA, and am proud of my work. I do not mind being a dependent provider, I don't have to be at the top of the food chain. I actually work with a significant amount of autonomy anyway, which I enjoy as well. I also feel like I practice with a lot of critical thinking, and not just "protocol driven" like my profession is frequently criticized for. It's also great to leave at the end of the day without having to deal with any bureaucracy.

I guess what it boils down too is that I'm disappointed that I didn't fulfill my dream. Being a PA is great, but it's not being a doctor. I knew I would feel this way because I know the PA profession is no substitute for the MD degree, but I think I was hoping my nagging desire to become a physician would just subside. Maybe I just need more time, but so far it hasn't. I worry about the desire getting worse.

Here's why going back to med school wouldn't work for me:
-I have 2 young kids and want more. I love spending lots of time with them and can't justify missing out on the next 7ish years of their lives.
-Going back to med school would put a lot of strain on my husband, and our marriage. PA school together was hard enough, and that was before kids. I'm almost certain we couldn't handle one of us going back to med school. My husband staying home, or us moving multiple times would prove quite difficult.
-The debt would be astronomical. We're finally closing in on paying off 2 PA school loans. I don't want to start over.
-I'm happy with my profession most days and don't need different letters after my name to feel good about myself and to continue my own medical education.

Reasons I want to go back:
-I get jealous when I see other young female physicians and I tell myself, I could've been her.
-It would fulfill my lifelong dream of being a physician.

It looks so obvious written out that the clear answer is to just stay put and be happy with my decision. But it's a pride thing really, I want the title and the respect.

Anyone else felt similarly and in the end decided not to go back? How do I cope with not becoming a physician when that's what I really wanted? Reassure me I'm making the right decision by not going back!
 
You’re still young, you could choose to revisit this decision when you’re done having children and they’re more independent, and you’re out of school debt.

As a woman you can have it all, you just might not be able to have it all at the same time. Medical schools aren’t going anywhere.
 
Status and ego are not a good motivation to go hundreds of thousands in debt (while missing out on the roughly 500k you'd make if you worked instead of pursuing med school) only to make less than half your current salary in residency, where you'd work far longer hours, only to get a job that's similar to the one you have now. Even if you did become a physician, presumably in hospital medicine, you may regret that you didn't become a dermatologist. Even if you became a dermatologist or some other high status specialist, you'll always find something to feel inferior about, if what's motivating you is status and respect.
 
Dont do it for pride, title, respect. I'd only do it if you really had a burning desire to understand medicine on a deeper level, and/or if you were unfulfilled in the scope of your current practice. Doesn't sound like either is the case! I know it's tough but try not to compare yourself to others in healthcare!
 
Don't do it. Your motivations are just not good enough. It's not worth it just for the ego boost of MD. You have a good thing going and good priorities. It's not worth it.
 
Harnandey0929 said:
I realize I'm posting this in the pre-med forum. I'm not sure where all the other PA to MD posts ended up, so I just figured it fit best here.

I'm 27, married, with two beautiful little girls (with hopes for 1-2 more kiddos), and have been working as a PA in hospitalist medicine for 3 years now. I'm about 30K away from paying off my student loans (woo!) and make about $120K a year. A pretty good gig I'd say!

Yet, I sometimes feel like I should've fulfilled my lifelong dream and went to med school.

Being a physician was what I wanted to do since the 3rd grade. I changed my mind late in my junior year of college right after meeting my husband (who was also pre-med). We both decided to change our career goals and we went to PA school together after realizing we wanted a big family and wanted more family and home time together. I was so close to applying that I had even taken the MCAT, and I think I did quite well, scoring a 34 with a 3.9 GPA (before the MCAT change of course).

I'm satisfied as a PA, and am proud of my work. I do not mind being a dependent provider, I don't have to be at the top of the food chain. I actually work with a significant amount of autonomy anyway, which I enjoy as well. I also feel like I practice with a lot of critical thinking, and not just "protocol driven" like my profession is frequently criticized for. It's also great to leave at the end of the day without having to deal with any bureaucracy.

I guess what it boils down too is that I'm disappointed that I didn't fulfill my dream. Being a PA is great, but it's not being a doctor. I knew I would feel this way because I know the PA profession is no substitute for the MD degree, but I think I was hoping my nagging desire to become a physician would just subside. Maybe I just need more time, but so far it hasn't. I worry about the desire getting worse.

Here's why going back to med school wouldn't work for me:
-I have 2 young kids and want more. I love spending lots of time with them and can't justify missing out on the next 7ish years of their lives.
-Going back to med school would put a lot of strain on my husband, and our marriage. PA school together was hard enough, and that was before kids. I'm almost certain we couldn't handle one of us going back to med school. My husband staying home, or us moving multiple times would prove quite difficult.
-The debt would be astronomical. We're finally closing in on paying off 2 PA school loans. I don't want to start over.
-I'm happy with my profession most days and don't need different letters after my name to feel good about myself and to continue my own medical education.

Reasons I want to go back:
-I get jealous when I see other young female physicians and I tell myself, I could've been her.
-It would fulfill my lifelong dream of being a physician.

It looks so obvious written out that the clear answer is to just stay put and be happy with my decision. But it's a pride thing really, I want the title and the respect.

Anyone else felt similarly and in the end decided not to go back? How do I cope with not becoming a physician when that's what I really wanted? Reassure me I'm making the right decision by not going back!
Click to expand...

If I'm reading your post right, you're essentially saying that you'd be sacrificing your family for your career. Is that worth it to you?
 
Harnandey0929 said:
I realize I'm posting this in the pre-med forum. I'm not sure where all the other PA to MD posts ended up, so I just figured it fit best here.

I'm 27, married, with two beautiful little girls (with hopes for 1-2 more kiddos), and have been working as a PA in hospitalist medicine for 3 years now. I'm about 30K away from paying off my student loans (woo!) and make about $120K a year. A pretty good gig I'd say!

Yet, I sometimes feel like I should've fulfilled my lifelong dream and went to med school.

Being a physician was what I wanted to do since the 3rd grade. I changed my mind late in my junior year of college right after meeting my husband (who was also pre-med). We both decided to change our career goals and we went to PA school together after realizing we wanted a big family and wanted more family and home time together. I was so close to applying that I had even taken the MCAT, and I think I did quite well, scoring a 34 with a 3.9 GPA (before the MCAT change of course).

I'm satisfied as a PA, and am proud of my work. I do not mind being a dependent provider, I don't have to be at the top of the food chain. I actually work with a significant amount of autonomy anyway, which I enjoy as well. I also feel like I practice with a lot of critical thinking, and not just "protocol driven" like my profession is frequently criticized for. It's also great to leave at the end of the day without having to deal with any bureaucracy.

I guess what it boils down too is that I'm disappointed that I didn't fulfill my dream. Being a PA is great, but it's not being a doctor. I knew I would feel this way because I know the PA profession is no substitute for the MD degree, but I think I was hoping my nagging desire to become a physician would just subside. Maybe I just need more time, but so far it hasn't. I worry about the desire getting worse.

Here's why going back to med school wouldn't work for me:
-I have 2 young kids and want more. I love spending lots of time with them and can't justify missing out on the next 7ish years of their lives.
-Going back to med school would put a lot of strain on my husband, and our marriage. PA school together was hard enough, and that was before kids. I'm almost certain we couldn't handle one of us going back to med school. My husband staying home, or us moving multiple times would prove quite difficult.
-The debt would be astronomical. We're finally closing in on paying off 2 PA school loans. I don't want to start over.
-I'm happy with my profession most days and don't need different
Click to expand...
Harnandey0929 said:
I realize I'm posting this in the pre-med forum. I'm not sure where all the other PA to MD posts ended up, so I just figured it fit best here.

I'm 27, married, with two beautiful little girls (with hopes for 1-2 more kiddos), and have been working as a PA in hospitalist medicine for 3 years now. I'm about 30K away from paying off my student loans (woo!) and make about $120K a year. A pretty good gig I'd say!

Yet, I sometimes feel like I should've fulfilled my lifelong dream and went to med school.

Being a physician was what I wanted to do since the 3rd grade. I changed my mind late in my junior year of college right after meeting my husband (who was also pre-med). We both decided to change our career goals and we went to PA school together after realizing we wanted a big family and wanted more family and home time together. I was so close to applying that I had even taken the MCAT, and I think I did quite well, scoring a 34 with a 3.9 GPA (before the MCAT change of course).

I'm satisfied as a PA, and am proud of my work. I do not mind being a dependent provider, I don't have to be at the top of the food chain. I actually work with a significant amount of autonomy anyway, which I enjoy as well. I also feel like I practice with a lot of critical thinking, and not just "protocol driven" like my profession is frequently criticized for. It's also great to leave at the end of the day without having to deal with any bureaucracy.

I guess what it boils down too is that I'm disappointed that I didn't fulfill my dream. Being a PA is great, but it's not being a doctor. I knew I would feel this way because I know the PA profession is no substitute for the MD degree, but I think I was hoping my nagging desire to become a physician would just subside. Maybe I just need more time, but so far it hasn't. I worry about the desire getting worse.

Here's why going back to med school wouldn't work for me:
-I have 2 young kids and want more. I love spending lots of time with them and can't justify missing out on the next 7ish years of their lives.
-Going back to med school would put a lot of strain on my husband, and our marriage. PA school together was hard enough, and that was before kids. I'm almost certain we couldn't handle one of us going back to med school. My husband staying home, or us moving multiple times would prove quite difficult.
-The debt would be astronomical. We're finally closing in on paying off 2 PA school loans. I don't want to start over.
-I'm happy with my profession most days and don't need different letters after my name to feel good about myself and to continue my own medical education.

Reasons I want to go back:
-I get jealous when I see other young female physicians and I tell myself, I could've been her.
-It would fulfill my lifelong dream of being a physician.

It looks so obvious written out that the clear answer is to just stay put and be happy with my decision. But it's a pride thing really, I want the title and the respect.

Anyone else felt similarly and in the end decided not to go back? How do I cope with not becoming a physician when that's what I really wanted? Reassure me I'm making the right decision by not going back!
Click to expand...
How do you feel your scope in practice differs from that of the MD hospitalists you work with?
 
From a financial perspective, you would lose a minimum of 120K x 7 and gain approximately 200-300K in debt from school. Let us assume 1 million in opportunity cost and debt. When factoring in interest you will play another 200-400K. So total cost about $1.2 million.

Those 7 years also come with a major family cost as well. You will unquestionably have much less time to spend with your kids. Having more kids is going to be exceedingly difficult, although not impossible. Finally, this will put a lot of strain on your marriage. I think you are underestimating this effect on your family. You are going to be thrusting a lot of the care on your husband first of all. Even with the most understanding spouse, this will lead to some degree of resentment. It is much easier, earlier in life when you don't have kids. I have seen this kind of thing destroy marriages in medicine. And, while people dont like to admit it, there is a stigma associated with a woman being in a more respected position than her husband. Your husband won't admit it, but this will weight on him. This will also be magnified by the fact that you are in the same field.

Finally, back to the economics, they are not so clearcut. It all depends on what you do- $120K after taxes is likely around 85K. If you are outpatient and make 200K, you only bring in 135K after taxes; 50K more. At that point, we're talking 25 years until you break even...

No one can tell you what is right for you and your family. The calculus would be different if you weren't already in a reasonable job with a reasonable salary and you didn't have kids.
 
Instatewaiter said:
From a financial perspective, you would lose a minimum of 120K x 7 and gain approximately 200-300K in debt from school. Let us assume 1 million in opportunity cost and debt. When factoring in interest you will play another 200-400K. So total cost about $1.2 million.

Those 7 years also come with a major family cost as well. You will unquestionably have much less time to spend with your kids. Having more kids is going to be exceedingly difficult, although not impossible. Finally, this will put a lot of strain on your marriage. I think you are underestimating this effect on your family. You are going to be thrusting a lot of the care on your husband first of all. Even with the most understanding spouse, this will lead to some degree of resentment. It is much easier, earlier in life when you don't have kids. I have seen this kind of thing destroy marriages in medicine. And, while people dont like to admit it, there is a stigma associated with a woman being in a more respected position than her husband. Your husband won't admit it, but this will weight on him. This will also be magnified by the fact that you are in the same field.

Finally, back to the economics, they are not so clearcut. It all depends on what you do- $120K after taxes is likely around 85K. If you are outpatient and make 200K, you only bring in 135K after taxes; 50K more. At that point, we're talking 25 years until you break even...

No one can tell you what is right for you and your family. The calculus would be different if you weren't already in a reasonable job with a reasonable salary and you didn't have kids.
Click to expand...
I completely agree with all of that. Im not going back because of that, which is what i mentioned in my post. I just want that part of my brain (my ego as others have put it) to lay my med school dreams to rest. Hearing from all of you support my decision to not go back is helping with that. So thank you!
 
Reader88 said:
How do you feel your scope in practice differs from that of the MD hospitalists you work with?
Click to expand...
In my practice specifically, as it differs greatly among hospitals, while I pretty much function autonomously, I do take on the simpler, much less complicated patients, and pretty much stay out of the ICU. I can see a patient admit through discharge with no physician involvement required. But, if my patient is deteriorating or I'm stumped on a problem, I'm calling the doc I'm working with right away. Otherwise we function rather similarly.
 
can’t PAs do a bunch of stuff now? When you go the ER, you see PAs most of the time. Maybe you should find more to do it that’s what you want.

With 2 and later 4 kids and already having a good career, I think it’s a mistake to go through residency and long hours. PA is good and you shouldn’t feel less than an MD. It’s like family medicine doctors being jealous of neurosurgeons, what is the point exactly? They all serve a purpose.


Sent from my iPhone using SDN mobile
 
The math depends on your specialty choice but let’s just say you’d make $350k once you’re an attending. After taxes, let’s call that a $150k raise. With the debt and lost earning years, you might break even after a decade as an attending (or ~18ish years from now). It’s definitely not worth it to be a physician hospitalist. This only makes sense if you want a clinical practice that is absolutely only available to physicians (surgeon, IR, Rad Onc, etc).

It sounds like your marriage might not survive this stress. If that’s the case, you definitely can’t plan to go back to med school and add more kids to the equation.
 
JeSuisUnDoc said:
can’t PAs do a bunch of stuff now? When you go the ER, you see PAs most of the time. Maybe you should find more to do it that’s what you want.

With 2 and later 4 kids and already having a good career, I think it’s a mistake to go through residency and long hours. PA is good and you shouldn’t feel less than an MD. It’s like family medicine doctors being jealous of neurosurgeons, what is the point exactly? They all serve a purpose.


Sent from my iPhone using
Click to expand...
Yes the PA profession is pretty awesome, and PAs all over are doing more and more. Procedures aren't really my deal, I might want to dabble into ultrasound stuff in the future, but none of the docs I work with even do procedures so that's not a big deal. They're also pretty supportive of me and my PA colleagues picking up higher acuity patients, so I could certainly make gains that way. Or I could jump ship and change specialties in a few years. That is the beauty, you can really make of the profession what you'd like.
 
Gastrapathy said:
The math depends on your specialty choice but let’s just say you’d make $350k once you’re an attending. After taxes, let’s call that a $150k raise. With the debt and lost earning years, you might break even after a decade as an attending (or ~18ish years from now). It’s definitely not worth it to be a physician hospitalist. This only makes sense if you want a clinical practice that is absolutely only available to physicians (surgeon, IR, Rad Onc, etc).

It sounds like your marriage might not survive this stress. If that’s the case, you definitely can’t plan to go back to med school and add more kids to the equation.
Click to expand...
Yikes, that math is sobering! Certainly doesn't make sense financially. And yeah, I'm not about to jeopardize my marriage for a title.
 
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