PA end goal. Where do I go from here?

[MattC1420]

Hello everyone,

A little about myself. I have been working as an EMT in the state of Georgia for about four years now. I have two months left of my paramedic course. When I graduate from my paramedic school I will have an associates degree. Halfway through paramedic school, I decided that I did not want to be in EMS my whole career but that my experience in EMS can be a good stepping stone for higher career opportunities. I decided after much thought that I want to become a physician assistant. It was a tough choice between choosing a nursing school and then going to get my NP but I really just thought to myself about the nursing model and medicine model. I am not sure if I would be happy with using the nursing model my whole career compared to the medicine model. I really enjoy the medicine model. The issue I am running into is my age. I am 25 years old right with an associates degree in two months. I know I need to attain my bachelor's degree prior to applying to a PA school. I do not know many options I have with an associates degree in paramedicine that can go further into attaining a bachelors degree expect Health Service Sciences. This degree is pretty pointless to me and I want to end up getting a bachelors degree that will allow me to fall back on in case I do not get accepted into a PA school.

I was debating getting my nursing through a paramedic to RN bridge program but then I would still only have associates and I would still need to get my BSN prior to applying to PA school. It sounds good but too me it sounds like extra work that may actually slow my progress. I want to get into a PA school before the age of 32.

Looking for some advice on anyone who may have been in my position and what route they may have taken. My goal is to attain a bachelors degree from my paramedic that will enable to find a good career while still working towards my PA or worse case will enable me to fall back on if PA school does not work out. That's why I was working towards thinking maybe getting my BSN but I am worried about my grades. Nursing school is hard and I do not want to take a more challenging route if I do not have too. I just do not know many options other than BSN-PA from a paramedic.

Thank you in advance to anyone who has read my post.

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[pamac]

If you are set on becoming a PA, then it’s less efficient for you to go to all the trouble of getting a BSN. It’s a difficult enough stepping stone to the point that it’s not much of a stepping stone. It mostly makes sense to use a BSN to become an NP. You very rarely see BSNs opting to forgo the opportunity to become an NP. The benefits of Np practice vs PA re simply too high. I literally make over $60k more per year being an independent NP in psyche than being a dependent PA in psyche.

 

[MattC1420]

If you are set on becoming a PA, then it’s less efficient for you to go to all the trouble of getting a BSN. It’s a difficult enough stepping stone to the point that it’s not much of a stepping stone. It mostly makes sense to use a BSN to become an NP. You very rarely see BSNs opting to forgo the opportunity to become an NP. The benefits of Np practice vs PA re simply too high. I literally make over $60k more per year being an independent NP in psyche than being a dependent PA in psyche.

That is exactly what I was thinking too myself as well. The only reason why I considered doing the BSN over other bachelor degree choices was due to the luxury of being able to fall back on a good career if PA does not work out.

I am assuming you are an NP and you are more biased towards the NP route. I have nothing against NP and what they offer to the medical field. I am just more into the PA route and the title if that makes sense. I am not sure I would be as happy as an NP compared to being a PA if that makes sense. I know my reasons sound selfish and stupid but that is just how I think. I also like the number of clinical hours PA have to do and I love the ability that PA has more luxury to jump from different specialties if they so desire.

Thank you for your response friend.

 

[pamac]

I had a biology degree, premed prerequisites, and interview invites to PA schools when I decided to get my nursing degree and go to NP school instead of continuing to head towards PA school. I hear you on the training. It’s good training. The other things you mention aren’t as compelling.

To begin with, specialty jumping is becoming less common. Your physician boss will want you to have as much pertinent specialization as you can have. They won’t pay as much for your years of experience as an ER PA if they are looking for a derm PA. You run the risk of starting back near the bottom of the pay scale of you jump around. Expertise is key, and if you change jobs all the time, you’ll be behind the curve. Folks just aren’t jumping around as much. It’s not as lucrative for you or those who will employ you.

You can expect to pay $100,000 at least for PA school. You can expect to pay $30,000 for most NP programs. My employer helped pay for NP school as well.

You can’t work during PA school. I made over $80,000 per year as an RN while in NP school. I also networked with local physicians and NPs for jobs, so I had 6 offers waiting for me when I was done. I could have had 12 if I wanted them. All of them were good offers, with no compromising on my part. I got the specialty I wanted, for the wage I wanted, in the location I wanted. My FNP friends are doing well in that regard. All have jobs lined up before they graduate.

I can always open up my own practice, employ other NPs, and set my own terms independently from the business inclinations of a physician employer.

I completed much more than the minimum hours that many critics complain that NPs “all” do. Nothing says that you can’t do more clinical hours, so at my expense, I stayed in school longer and had more clinical time.

I am very happy in my role, title, and training. My title belongs to me, and not the physician. You should give some serious thought to the nursing pathway.

Final point... if you go into nursing, you will have to spend more time and money getting the prerequisites for PA school. Not worth it. And your nursing degree would go to waste while you are not using it while in Pa school. You gotta do what you gotta do, and I’m not suggesting that you shouldn’t take a seat in nursing school that someone else would appreciate, but it would just be a waste of your time to use it as a backup, or a stepping stone for Pa school. It was a stepping stone for me to get into Np school, but that is a natural transition.

 

[pamac]

If you don’t have really good grades, you also run the real risk of applying and applying and applying to get into PA school. I’ve watched people apply over and over again to not get in the next year. If you have time to kill, go for it. If your GPA isn’t above a minimum 3.3 for your sciences and cumulative, you need to realize your chances are slim of getting into Pa school.

 

[Apollo1]

Other side of the coin, OP:

1. NP school does cost less, but the hours required for completion of the training are far less. There's a strong inference (along with other factors) that the quality of education is lesser. While I believe what PAMAC says regarding their education, it would probably be more of the exception rather than the standard.

2. Many, if not most NP programs have you arrange your own clinicals. While this appears like a great opportunity regarding flexibility, you're one face in a sea of NP students looking for preceptors. You also have no way of guaranteeing how involved your preceptor will allow you to be in a clinical setting.

3. Yes, you can work during NP school, but your income will vary based on the specialty you work in as well as where you're located. Tuition assistance and employer agreeability are not guaranteed. Don't make any assumptions.

4. Self-governance regarding NP career choices is due to being under their respective Board of Nursing, not Board of Medicine. Physicians generally don't support midlevel autonomy, and I assume would not allow for NP's to act independently if they were included in the same regulatory structure.

5. Everyone has a boss.

Long story short, if you want to go to PA school you should take the typical premed classes while gaining HCE/PCE. PAMAC , I and several others can give you our n=1, however its ultimately on you as to what model of training you want to practice under.

 

[pamac]

In the near future, every recertifying NP program will be required to provide clinicals. That’s bodes well for the future I think. I was able to get some of the best clinical sites where I live, but I know that it can be a struggle for some. On the flip side of that, I didn’t have to relocate to a different city to do clinicals like I would have for Pa school. That’s why all of my clinical sites offered me jobs... I spent my time in NP school networking, rather than going away to school and coming back after two years to look for a job.

Every NP student I know or have known works/worked at least a little bit during school. I worked full time. It can be done, and you’ll make nurses wages, which are pretty good. If you are working part time, you can even make more hourly than I did. I guess it all just depends. Folks who think nurses make more in different specialties dont know nursing at all. Pays about the same in a hospital wherever you work. ICU nurses make the same as a medical surgical nurse.

In a clinical setting, your preceptor will, in fact, be expected to provide a standard of participation, unlike what was suggested above. It’s part of the preceptorship agreement. It’s no different than what a Pa student would have. I guess your preceptor could ignore you and have you sit in a corner, but that could happen to PA students as well.

Yes, tuition reimbursement is variable. But my facility, like many, many others out there, provided tuition reimbursement for nurses seeking extra education. They don’t do that for PAs, because PAs go away to school and don’t work while in school. One of the job offers I had also dangled some money to repay any student loans.

Yes, most physicians don’t support non physician providers very well under their regulatory structure if NPs are overseen by the board of medicine. That’s why in most independent states they aren’t overseen by the BOM. Nurses lobby for that distinction and they win it.

So yeah... n=1. But my n=1 is more informed than a prospective medical or PA student’s n=1. That’s because as far as the pathway goes A) I saw it done, B) I did it myself, C) I’ve seen other people doing it themselves, and D) I know lots of people all over the place that are doing that same thing. I went in to my journey with a desire to get all of those things accomplished, and then it happened according to how hard I pursued it. The cards didn’t just fall this way for me, and I think that’s the core of what I’m suggesting. If it were a fluke, then it was a convenient fluke that the things my mentor guided me towards all fell into place. I’d like to take credit for all if that, but it was networking and relationships that I built up that helped me with the game plan. Nobody will hand everything to you, but if you want tuition reimbursement, it’s out there. If you want to work during school, you can. If you want to be independent, its possible. If you want good clinicals with the best people, go find them. Find the do-ers in life and make friends with them (mostly by being a do-er yourself). But certainly, take the opinion of someone that isn’t informed with healthy skepticism.

 

[Makati2008]

In the near future, every recertifying NP program will be required to provide clinicals. That’s bodes well for the future I think. I was able to get some of the best clinical sites where I live, but I know that it can be a struggle for some. On the flip side of that, I didn’t have to relocate to a different city to do clinicals like I would have for Pa school. That’s why all of my clinical sites offered me jobs... I spent my time in NP school networking, rather than going away to school and coming back after two years to look for a job.

Every NP student I know or have known works/worked at least a little bit during school. I worked full time. It can be done, and you’ll make nurses wages, which are pretty good. If you are working part time, you can even make more hourly than I did. I guess it all just depends. Folks who think nurses make more in different specialties dont know nursing at all. Pays about the same in a hospital wherever you work. ICU nurses make the same as a medical surgical nurse.

In a clinical setting, your preceptor will, in fact, be expected to provide a standard of participation, unlike what was suggested above. It’s part of the preceptorship agreement. It’s no different than what a Pa student would have. I guess your preceptor could ignore you and have you sit in a corner, but that could happen to PA students as well.

Yes, tuition reimbursement is variable. But my facility, like many, many others out there, provided tuition reimbursement for nurses seeking extra education. They don’t do that for PAs, because PAs go away to school and don’t work while in school. One of the job offers I had also dangled some money to repay any student loans.

Yes, most physicians don’t support non physician providers very well under their regulatory structure if NPs are overseen by the board of medicine. That’s why in most independent states they aren’t overseen by the BOM. Nurses lobby for that distinction and they win it.

So yeah... n=1. But my n=1 is more informed than a prospective medical or PA student’s n=1. That’s because as far as the pathway goes A) I saw it done, B) I did it myself, C) I’ve seen other people doing it themselves, and D) I know lots of people all over the place that are doing that same thing. I went in to my journey with a desire to get all of those things accomplished, and then it happened according to how hard I pursued it. The cards didn’t just fall this way for me, and I think that’s the core of what I’m suggesting. If it were a fluke, then it was a convenient fluke that the things my mentor guided me towards all fell into place. I’d like to take credit for all if that, but it was networking and relationships that I built up that helped me with the game plan. Nobody will hand everything to you, but if you want tuition reimbursement, it’s out there. If you want to work during school, you can. If you want to be independent, its possible. If you want good clinicals with the best people, go find them. Find the do-ers in life and make friends with them (mostly by being a do-er yourself). But certainly, take the opinion of someone that isn’t informed with healthy skepticism.

I tend to agree with most of your post but you can work during PA/Med school. I did during both. It’s all about time management. Also I had tuition reimbursement offered for both.

 

[pamac]

I tend to agree with most of your post but you can work during PA/Med school. I did during both. It’s all about time management. Also I had tuition reimbursement offered for both.

That’s true. I think that there are some nuances to your situation that bear noting. While in med school, you were a PA. That meant you had A) a good deal of knowledge already onboard. Medical school is a lot more refined knowledge, but it can’t hurt to know the lay of the land vs folks that don’t really know what to study for. B) As a well paid PA, it was worth your time to pick up shifts because the pay was high. $1000 or so for a shift here and there is a lot different than what a paramedic or other entry level healthcare worker gets out of their shift, especially as a percentage of the tuition outlay. Most folks time would be better spent studying so they don’t fail. That’s the math that often goes in to whether to work during school. It’s maybe worth the risk when your payout is high. And the time you lose, and effort you put in is almost amplified in difficulty when you add more to juggle for an extra few thousand.

That’s the calculation for medical school. If you pulled that off in PA school, then more power to you. The better the student, the easier that probably is, and it probably reflects study skills, time management, and discipline overall. It can be done, but I feel like the more people add on to the load, the more chance of failure in that regard. It’s like when I go out to work in a project in my yard. Something that in my mind will take an hour usually takes at least 3 times that. Folks who go into school expecting to work often hit that kind of reality when it comes to how much work they think they will be able to do outside of school.