Febrifuge said:
I totally agree. Good post, Ock. You hit the nail on the head. 👍
Hey Feb --I've been meaning to email you.
In the centrifuge of my life I've recently decided to turn 180 degrees and am now staring down the barrel of the med school path rather than PA school. A couple of reasons (with no offense to anyone in either camp):
1. This issue of mastery: Philosophically I believe that life should be the slow (fast is fine too though) progression of whatever one's life work is toward mastery. As I thought about this, I kept hitting an intellectual ceiling with the constraints of PA. PAC2DOC had made a specific comment that I really didn't like but he didn't mean it as such. He said in an earlier post regarding DrNPs and PAs that,
"I am actually loving this development by NP's to attain DNP status, because it just means more jobs for PA's who know what it means to be subordinate and respectful to their physician colleagues. A subordinate stance goes a long way toward enhancing acceptance and gaining priviledges [sic]."
Now while I have a really hard time with that sentiment (the notion of subordinate=privileges...WHAT?...ability should equal privileges and any job where it doesn't I don't want to toil), I do respect PAC2DOC for his perspective. What the quote made me start thinking was how such an attitude reflected in a larger sense on the real and perceived role of a PA and how that role grated against my idea of mastery in one's chosen profession. What I mean is that were I to choose PA and become the absolute best PA who ever lived, I would still, structurally and by definition be "subordinate". In a very real sense there would be a ceiling to the level of mastery that I could ever possibly attain, for I would always be subordinate to an MD.
This is diffent for a nurse, for example, because they are trained under a different paradigm with different goals. For a nurse, mastery is an ongoing progression, but for a PA, educated under the medical paradigm, mastery has a limit; and that limit is the structural boundary (or distinction if you prefer) between the PA and the MD.
2. The cost-benefit of both paths: Assuming that the prereqs are pretty similar and the that the first two years of both are similar in terms of committment, I end up looking further down the road. The point at which I feel the cost-benefit ratio of DO overtakes PA is when I consider the unprecended career options one enjoys as an MD/DO: policy, public heath, administration, sub-specialization, international practice, personal practice, etc. That is not to say in anyway that PAs are locked down. In fact I found the ability to change specialties by virtue of changing jobs as one of the key benefits of PA (I still do). But taken to a logical end, regardless of multi-specialty flexibility in PA, I perceive the mobility as inherently limited by the structure of the job itself. For me, the additional cost in terms if years and dollars to pursue MD/DO (DO for me) is worth it in the longer run.
3. The academics of it all: they are to some degree my ballywick. This is my first (and final) semester back at school in more than 10 years. I had a great GPA then and, now back after an extended hiatus, am finding that the academics that used to come so easily have not betrayed me with age. That I am also taking and loving BioI and doing great has served to embolden my feeling that I can sustain the protracted challenge of med school. On my lab days I am literally at school straight-out from 9am to 9pm and when I leave I am exhilarated. I'll finish my undergrad at UMass Boston in late May, start EMT training at Northeastern in late March, am planning on joining an archeological field study in Belize in June (3 weeks) and then hopefully join an ED as a tech once I return. From there it's post-bacc in the fall to finish my prereqs. Somehow, as challenges become experiences I feel like med school and not PA school is the challenge I'm increasingly primed for.
Yup, it's a personal decision and as DocWagner says, it's the degree to which you align your sense of self with your profession versus, as you mention, the degree it remains vocational. I think for me I can't separate my work from myself--consider it a character flaw...
Sorry for the long-ass post,
OckhamsRzr
