PA or MD?

[EddieL]

Hey there,

I know this has been asked before, and I have read over pretty much every thing relating to it, but hear me out. I've been bouncing between the idea of being a PA and MD for a while now, and would like to get the opinions of some others.

I'm looking to go into pediatrics. I know this isn't one of the higher paid fields, but I really don't care about the pay as long as I can live somewhat comfortably on it. I've shadowed several pediatricians and sort of figured out that this is what I want to do.

Now, here comes the PA vs MD debate. I've been thinking, and these are pretty much my thoughts at this point:

PA:

• 5-6 years training
• Good salary (80k+)
• Job flexibility (can change between fields)
• Less loans
• Not a doctor
• Majority of public have no idea what one is
• Finish at 23-24! Almost as long as a normal degree

MD/DO:

• 8 yrs for undergrad/med school, 3+ for residency
• Salary better than PA (130k+)
• Limited job flexibility
• More loans
• The title "Dr"
• More autonomy
• More prestige
• Be near 30 when done...

I'm still really lost.

I know I want to work in pediatrics, but I don't know if I could handle not being an MD. At the same time though, if I can do a pretty similar thing in 5-6 years vs 11 years, wouldn't it make more economical sense to go with the PA route? For any health workers/pa's out there, do you know any PA/NP who feel inferior to MD's to the point where they wish they became one? Even if you can't answer any of these questions, which would you pick?

Thanks so much,

EddieL

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[Starpower]

Warning: Pediatrics is one of the lowest paid PA specialties, the average yearly salary is approximately 70K. You can supplement with other work (ER, NICU, surgery, etc), but that's the baseline. More experience will bring more salary, but you're not likely to ever make more than 100K as a pediatric PA.

I take it you're in your early 20s ... goto med school and become a Pediatrician. Do your residency in Peds and learn absolutely everything there is to know. I'm a PA student who recently decided on Peds as my choice of career ... maybe I'll come work with you someday.

 

[gluon999]

Warning: Pediatrics is one of the lowest paid PA specialties, the average yearly salary is approximately 70K. You can supplement with other work (ER, NICU, surgery, etc), but that's the baseline. More experience will bring more salary, but you're not likely to ever make more than 100K as a pediatric PA.

If the low salary of a Peds - PA is your reason for encouraging the OP to become an MD, then that is a terrible reason. Pediatricians are the lowest earning of all physicians.

 

[deleted87716]

Pediatricians are the lowest earning of all physicians.

True...their median income was "only" $202,832 last year.

http://www.cejkasearch.com/compensation/amga_physician_compensation_survey.htm

 

[EddieL]

True...their median income was "only" $202,832 last year.

http://www.cejkasearch.com/compensation/amga_physician_compensation_survey.htm

Fair point, but they do start on the lower end of salary range.

Warning: Pediatrics is one of the lowest paid PA specialties, the average yearly salary is approximately 70K. You can supplement with other work (ER, NICU, surgery, etc), but that's the baseline. More experience will bring more salary, but you're not likely to ever make more than 100K as a pediatric PA.

I take it you're in your early 20s ... goto med school and become a Pediatrician. Do your residency in Peds and learn absolutely everything there is to know. I'm a PA student who recently decided on Peds as my choice of career ... maybe I'll come work with you someday.

I'm more leaning toward med school at this point. I just sort of keep getting pulled into the quicker PA route, forcing myself to ignore the long-term effects of that decision.

It's not really the pay that's pulling me in. My aunt has a wonderful law practice and she has asked me countless times to go JD so I can take it over. However, that's not where my interests rest. I can't really see myself doing anything but medicine. Bleh. I don't know if I will be able to handle knowing I could have gone further.

For reference, how is being a peds PA? Could you tell me about what you want to do after graduation and what you did on your rotations if you got there yet? Thanks. And who knows, maybe we will some day!

 

[SOUNDMAN]

If you even have any desire to become a physician, then I wouldn't go the PA route. For me I had always wanted to be a physician, but decided a PA would be OK. So one year into the program I knew that I would end up back in medical school at some point. Sure enough three years after graduating PA school and practicing for that time, I returned to medical school.

Long road for sure

 

[Starpower]

If the low salary of a Peds - PA is your reason for encouraging the OP to become an MD, then that is a terrible reason. Pediatricians are the lowest earning of all physicians.

A "terrible" reason? It's not the only reason, but it's certainly one important reason. 200K is a lot more than 70K, and the OP did already say they were interested in pediatrics.

Anyhow, if you read the rest of my post I encouraged them to go and learn everything they can rather than simply take what seems like an easy road.

 

[Starpower]

For reference, how is being a peds PA? Could you tell me about what you want to do after graduation and what you did on your rotations if you got there yet? Thanks. And who knows, maybe we will some day!

Hey I'll be able to better answer your first question after I go to the national Pediatric PA conference this year (really looking forward to that ... lectures and labs from MDs/PAs/NPs, gonna rock). As for your second, I want to do Peds FP and work part-time in the ER.

And your third ... I did everything that the med student did (probably a bit more as I have more experience working with patients). My preceptor was awesome, a D.O. who is intelligent and wise. He didn't hold my hand, but was always there if I needed him. We didn't see too much more than the typical viral/bronchitis/pneumonia/derm bits, altho there were was a septic arthritis here and a pregnancy there. What I enjoyed a great deal was how much of a developmental dynamic there is in peds. You're there as the 'authority figure' and can really help to bring a point across to a patient, as well as help a parent better understand. You can bring home the importance of dental brushing, and even work with them on their literary abilities:

http://www.reachoutandread.org/

And of course, the best part is their follow-ups where the cough has lessened and the brightness is back in their skin. Of course, there are the not so happy moments ... like when we had to diagnose Down's to a mother who wasn't equipped to deal with it. But even then it takes a certain kind of person to be able to handle those types of situations.

 

[PUPPYBOY3765]

Hey there,

I know this has been asked before, and I have read over pretty much every thing relating to it, but hear me out. I've been bouncing between the idea of being a PA and MD for a while now, and would like to get the opinions of some others.

I'm looking to go into pediatrics. I know this isn't one of the higher paid fields, but I really don't care about the pay as long as I can live somewhat comfortably on it. I've shadowed several pediatricians and sort of figured out that this is what I want to do.

Now, here comes the PA vs MD debate. I've been thinking, and these are pretty much my thoughts at this point:

PA:

• 5-6 years training
• Good salary (80k+)
• Job flexibility (can change between fields)
• Less loans
• Not a doctor
• Majority of public have no idea what one is
• Finish at 23-24! Almost as long as a normal degree

MD/DO:

• 8 yrs for undergrad/med school, 3+ for residency
• Salary better than PA (130k+)
• Limited job flexibility
• More loans
• The title "Dr"
• More autonomy
• More prestige
• Be near 30 when done...

I'm still really lost.

I know I want to work in pediatrics, but I don't know if I could handle not being an MD. At the same time though, if I can do a pretty similar thing in 5-6 years vs 11 years, wouldn't it make more economical sense to go with the PA route? For any health workers/pa's out there, do you know any PA/NP who feel inferior to MD's to the point where they wish they became one? Even if you can't answer any of these questions, which would you pick?

Thanks so much,

EddieL

I think it is best not to worry about what you are going to specialize in now. Both programs require rotating through all the medical specialties. As you go through them, you may decide that you are interested in other specialties, too. Many students have changed their minds after doing the required rotations.

The thing with going the MD route is that you will gain a deeper understanding of the sciences, such as pathophysiology. I have done both programs and found that to be the case.

 

[BruceBanner]

If you even have any desire to become a physician, then I wouldn't go the PA route. For me I had always wanted to be a physician, but decided a PA would be OK. So one year into the program I knew that I would end up back in medical school at some point. Sure enough three years after graduating PA school and practicing for that time, I returned to medical school.

Long road for sure

I would agree. I was different in that I originally wanted to be a PA, then switched to the med school path and did that whole game (twice), then came full circle back to the PA career.

EddieL: I would implore you to really think about the cost of each. This is usually overlooked under the assumption that one will be able to just 'pay off' their debt in short order after they get a job. Rarely is this the case. I'm not saying go to PA school because it's cheaper, but if you are on the fence then debt should be a key factor in your decision. I say this because when you defer the enormous debt you have from UG and med school for your residency and fellowship, the compounding interest can pull your shorts down and rape your butt.

PA school is not cheap, but the advantage is you borrow for about 2 years then begin to work, rather than defer your loans through residency.

I just read a story in the Wall Street Journal about a 41-yr old pediatrician with $555,000 in student loan debt!!! She defaulted after her fellowship and got royally hammered. Granted her's is an extreme case, but debt is no joke man. Do you want to live the rest of your life owning somebody? Think about it. If you can go to a state U and a state med school that would help tremendously.

Really I see the decision as a give/take. Neither option is perfect, both are hard, and both have advantages and drawbacks.

 

[Starpower]

The thing with going the MD route is that you will gain a deeper understanding of the sciences, such as pathophysiology.

I would certainly say that it's much more than just a "deeper understanding of the sciences" (you say those same words a lot PUPPYBOY, I'm not sure if you realize that).

You will simply learn more in a pediatric residency, period, including more about labor and delivery, NICU, maternity, pathophysiology, labs, etc.

 

[Starpower]

I think it is best not to worry about what you are going to specialize in now. Both programs require rotating through all the medical specialties. As you go through them, you may decide that you are interested in other specialties, too. Many students have changed their minds after doing the required rotations.

This can be true for some, even for me ... I've always figured I'd be in the ER since I've worked in them for years. Yet on the 2nd day of my Peds rotation I knew it was where I belonged.

Still, the pediatrician who was my preceptor told me that he knew he would be a pediatrician even when he was in high school.

 

[PUPPYBOY3765]

I would certainly say that it's much more than just a "deeper understanding of the sciences" (you say those same words a lot PUPPYBOY, I'm not sure if you realize that).

You will simply learn more in a pediatric residency, period, including more about labor and delivery, NICU, maternity, pathophysiology, labs, etc.

DUH!!! No kidding! Of course one will gain more knowledge in ANY residency. What would be the point in spending 3 + years in a residency (and possibly a fellowship), if that were not the case? That was not my point. Oh well, forget it, I am not wasting anymore time on you.

 

[PUPPYBOY3765]

Delete

 

[EddieL]

I would agree. I was different in that I originally wanted to be a PA, then switched to the med school path and did that whole game (twice), then came full circle back to the PA career.

EddieL: I would implore you to really think about the cost of each. This is usually overlooked under the assumption that one will be able to just 'pay off' their debt in short order after they get a job. Rarely is this the case. I'm not saying go to PA school because it's cheaper, but if you are on the fence then debt should be a key factor in your decision. I say this because when you defer the enormous debt you have from UG and med school for your residency and fellowship, the compounding interest can pull your shorts down and rape your butt.

PA school is not cheap, but the advantage is you borrow for about 2 years then begin to work, rather than defer your loans through residency.

I just read a story in the Wall Street Journal about a 41-yr old pediatrician with $555,000 in student loan debt!!! She defaulted after her fellowship and got royally hammered. Granted her's is an extreme case, but debt is no joke man. Do you want to live the rest of your life owning somebody? Think about it. If you can go to a state U and a state med school that would help tremendously.

Really I see the decision as a give/take. Neither option is perfect, both are hard, and both have advantages and drawbacks.

Hi there,

Thanks for your replies. If I went the PA route, I would be in a 5 yr program with an expensive private university around here, graduating with nearly 150k in debt. This specific university gives out really crappy scholarships with their competitive programs (pharm, pa, pt, etc).

If I went med, I would go to a local public university, graduating with under 50k in debt (probably even less as I would be working in the summer to pay it off). My parents will likely foot some of that bill too. Add med school to that, then it gets ridiculous.

But my point is either way, I'm going to be owing a lot of money.

@Puppyboy, you're right, it is too early to be dead set on a speciality. I am open to pretty much anything, but I like working with kids so I have an eye on peds for now.

@Starpower, thanks for your reply and sharing the details of your rotations.

 

[PUPPYBOY3765]

delete

 

[morning]

Shadow PAs and physicians from a myriad of specialties. You need to do that for admission into any program, MD or PA, anyway. You will get a better understanding of each role.

Pediatrics is paid worse in any event no matter whether you're MD or PA, but that might not always be the case. If you want a "buy low, sell high" specialty, family medicine or pediatrics might be it.

It's worth it to note that pediatricians report some of the highest job satisfaction of all MDs, despite their low pay. It seems to be a job you are called to do no matter what the hassle.

I just read a story in the Wall Street Journal about a 41-yr old pediatrician with $555,000 in student loan debt!!! She defaulted after her fellowship and got royally hammered. Granted her's is an extreme case, but debt is no joke man. Do you want to live the rest of your life owning somebody? Think about it. If you can go to a state U and a state med school that would help tremendously.

There's a thread about her in the pre-allo forum and probably a bunch of other forums here (and other places too.) She went to a Caribbean school and did not have federal loans, plus most of her debt came from DEFAULTS and credit cards. She "earned" 50k of that debt just from one default. 550k debt is not cut-and-dried. It makes a nice headline but her case is far more complicated than that. It is not typical debt of a US graduate, at all.

 

[Segovia]

True...their median income was "only" $202,832 last year.

http://www.cejkasearch.com/compensation/amga_physician_compensation_survey.htm

Via AAMC, the upper end of the range is 202K, not the median.

http://www.aamc.org/students/cim/pub_pediatrics.htm