PA school

[rutpharm]

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how many years of schooling does it take to become a PA?

 

[deleted6669]

pa school itself is usually 2-3 years in length, however to be eligible most applicants already have a b.s. degree( 4 years), a professional degree or certificate(rn, paramedic, resp. therapist, etc.) that takes 1-2 years to acquire, + several years(3-5) of direct pt care experience. for me this worked out to 9 years of school as follows
bs(4 years)
paramedic school ( 1 year)
pa school( 3 years for bs #2)
masters completion-postgrad ( 1 year)

I also had 5 years experience as a medic before applying to pa school.
some programs( 5/135) allow you to apply right out of high school and complete a 4 year program for a bs or a 5 year program for an ms. I wouldn't recommend this route.

 

[12R34Y]

OR you can get your 4 yeard Bachelor's and while you are in school work as a patient care tech or nursing assistant and go into PA school. 6 years.

This is how 2 of my good friends got into university of iowa's pa program (great by the way). they took a 4week EMT course over a summer during undergrad.

Typically nurses will not become PA's they will become Nurse practicioners.

just get a BS and shadow alot and work in a patient care setting.

that's enough. especially for some Bachelor programs out there. some of the master's programs are a little more competitive.

later

 

[deleted6669]

In fact about 30% of p.a.'s are former nurses. I work with several. NP and PA schools emphasize different things. people who want to be trained in the medical model to practice in any specialty(including primary care)go to P.A. school while those who are interested in counseling, psychosocial issues, primary care/obgyn/peds often choose NP programs. they are both valid pathways. most pa programs will be masters level in the next 5 years.

 

[12R34Y]

emedpa,

My former medical director at the ambulance service i used to work for was a cardiothoracic surgery PA before returning to DO school to be an EM doc. real nice guy.

is that your plan?

later

 

[deleted6669]

YUP- em, fp, or em/fp. not quite sure yet.

 

[lalee]

Hey emedpa,
I would like your input...I am a single mom, currently a PT assistant (10yrs) working in homehealth. I have completed my prereqs for MD/DO programs and am finishing up additional classes for PA programs (masters). I have been going back and forth between PA and MD/DO for some time now. I am quite familiar with both roles and can definately see myself being happy with either one. My main concern (several) is :
1. debt. I am concerned about the debt I will incur with the PA program. If I decide on MD/DO, I know I will make enough to make payments, but on a PA salary, it might be more difficult.
2. Autonomy. Since I am currently in an assistant role, I know I desire more independence and am unsure whether transitioning to ANOTHER assistant role will put me into the same restricted type position.
3. One of the reasons why I have been considering the PA profession is family time. I wonder if the 3rd year of the MD/DO program is similar to the rotation year for PA school. If both are somewhat similar, would it be just as attainable for a single mom to finish 3rd year as the PA rotation year?
Your input would be greatly appreciated!
Thanks.

 

[deleted6669]

It sounds like you have great background for pa school, however if you are seriously considering md/do programs you should go that route. autonomy is a big issue and can be problematic if you don't find a good supervisor. some jobs it is not an issue because you work fairly independently and the doc just signs the charts, some jobs require a presentation on every pt so it just depends.paying back loans as a pa is not typically a problem because salaries range 65-120k to pay back 20-40k or so.the third year of med school is identical to the second year of pa school. some programs schedule 3rd year students and 2nd year pa students through the same office. if you want to run the whole show, go md/do. if you are happy with some oversight, go pa and save yourself several years of school. it is a choice which has to be made by each individual. for me, it's time to go back to school.

 

[hospPA]

Hello,
I wanted to comment on the "most nurses would go the NP route". I am an RN who went to PA school, and wanted to explain why. The most obvious reason for me was that all through nursing school, I liked medicine better. Nurses are trained in medicine in a round about way jumbled in with a lot of nursing theory crap (IMHO). I always thought that nursing theory got in the way of real medicine. Anyway, NP's and PA's are expected to practice medicine when they graduate. PA's are trained in medicine by physicians. No extra nursing theory. I felt that two years of training was a short time, and I needed as much training as possible in the art of medicine. Plus, PA clinical year is far more rigorous than NP clinicals. 2000 hours versus 500 ish?
Pat

 

[12R34Y]

The reason I have found that many nurses (the ones i know) who went on to NP training instead of the PA route is that NP's can practice independenltly. They do not require physician oversight. I realize most NP's work does involve physician oversight like PA's, but there reason was that they can "practice" without oversight if they choose.

I'm finishing up my first year of medical school and I personally think that PA training is superior, but I don't know of any nurses that went into PA school. All of my friends went into NP. Not to say that nurses don't go to PA school, but in my experience they don't.

later

 

[PACtoDOC]

Not only do NP's get to practice without "oversight", they also HAVE TO practice without a real EDUCATION. If patients honestly knew and understood what an NP is allowed to do compared with what they are trained to do, I think this would spell then end of NP's. Unfortunately, the NP lobby is strong like the RN lobby and has made great strides to keep their power. I will never work with an NP though.

 

[lloydchristmas]

Originally posted by PACtoDOC
Not only do NP's get to practice without "oversight", they also HAVE TO practice without a real EDUCATION. If patients honestly knew and understood what an NP is allowed to do compared with what they are trained to do, I think this would spell then end of NP's. Unfortunately, the NP lobby is strong like the RN lobby and has made great strides to keep their power. I will never work with an NP though.

PAC... you have made some real good comments in the past, but frankly, I'm surprised to hear this kind of ignorant generalization out of you. Ya, I agree that PA training is superior to NP training, but I don't care what school you go to, you learn your job on the job. I can go to NP or PA, whichever I choose. I'm choosing NP simply because of the lobby power. The greater the strength in govt, the more laws will be passed to create more independence and therefore new jobs for NPs. (I would've chose PA if the lobby power was equal, though. I've already taken some courses in the FNP program, and it's true, the training sucks. But don't generalize. You set yourself up to be made into a fool by the 1 in 10,000 NPs who may be incredibly good at what they do, for whatever reason (maybe they have no life and self study medicine all the time). Point is, generalizations consistently come from people who lack intelligence. You haven't ever sounded like you lack intelligence, so maybe this was just a brain fart or something.

 

[PACtoDOC]

Sorry if you are offended by the truth Lloyd, but I am not here to help you rationalize your decision to become an NP. The bottom line is that NP's have laughable clinical training in their clinical phase. Many only require 500 hours and back up their requirment by saying that nurses have all that time served as an RN. Serving as an RN is no replacment for clinical time as a provider. Nurses are not taught to interpret or diagnose disease. Your statement that health care providers are made on the job is also weak. So then why do physicians go to 4 years of medical school? We should just give them their title in advance and let them learn afterward right? The fact is, all other providers that have the ability to prescribe dangerous drugs, and treat patients, have the ability to do so the day they graduate. If you think 500 hours of clinical training makes an NP ready to treat patients you are wrong. Yes, as you say, NP's have the ability to read on their own as students or even grow in their "clinical" expertise as time goes by. But, they will always have a fundamental lack of understanding of pathophysiology and mechanisms of disease because their education stinks overall. You said it yourself. I said I would never work with an NP as a physician, and this is my right. If that offends you then chalk this response up as another you don't like provided by me. I am sure we will agree on something again later.

 

[deleted6669]

Llloyd-have you considered doing a dual degree program pa/np. there are a few out there and they are all taught at least to the minimum pa standard but if you go in as an rn you are eligible for both pa/np boards when you are done. the 2 that I know of off hand are uc davis and stanford. just a thought-e

 

[lloydchristmas]

Originally posted by PACtoDOC
Sorry if you are offended by the truth Lloyd, but I am not here to help you rationalize your decision to become an NP. The bottom line is that NP's have laughable clinical training in their clinical phase. Many only require 500 hours and back up their requirment by saying that nurses have all that time served as an RN. Serving as an RN is no replacment for clinical time as a provider. Nurses are not taught to interpret or diagnose disease. Your statement that health care providers are made on the job is also weak. So then why do physicians go to 4 years of medical school? We should just give them their title in advance and let them learn afterward right? The fact is, all other providers that have the ability to prescribe dangerous drugs, and treat patients, have the ability to do so the day they graduate. If you think 500 hours of clinical training makes an NP ready to treat patients you are wrong. Yes, as you say, NP's have the ability to read on their own as students or even grow in their "clinical" expertise as time goes by. But, they will always have a fundamental lack of understanding of pathophysiology and mechanisms of disease because their education stinks overall. You said it yourself. I said I would never work with an NP as a physician, and this is my right. If that offends you then chalk this response up as another you don't like provided by me. I am sure we will agree on something again later.

Well, you're right about one thing... we'll agree to disagree; but that's about it. You made mention of why not give docs the title early. Of course they are better trained. It all depends on what the hell you're doing for a living when you're done. I've already got a job waiting for me (have had it waiting for me since before I was a RN). "Well they only have blah blah hours in clinicals..." And you think I have a weak argument?? Ya, the education stinks, but I've never met anyone I'd be comfortable with prescribing "dangerous drugs" right out of school, whether they have a MD, DO, PA, NP, or other. I think you're trying to justify your decision to go to med school in your own mind by downplaying all lesser trained professionals, even if it means sacrificing your own old title.

I was 6 months away from getting into med school 3 years ago, and I went backwards in my undergrad to get a degree in nursing so I could be a NP... and one of my close friends (a MD) showed me the light. I couldn't be happier about it. Lot's of the money, about 1% of the bullsh*t you'll have. But go get your Dr. title. It'll be justified in your own mind, and that's all that matters to you.

 

[lloydchristmas]

Originally posted by emedpa
Llloyd-have you considered doing a dual degree program pa/np. there are a few out there and they are all taught at least to the minimum pa standard but if you go in as an rn you are eligible for both pa/np boards when you are done. the 2 that I know of off hand are uc davis and stanford. just a thought-e

Thanks for the info... interesting, but I don't know why anyone in their right minds would do such a thing. What's there to gain?

 

[lalee]

Originally posted by lloydchristmas
I was 6 months away from getting into med school 3 years ago, and I went backwards in my undergrad to get a degree in nursing so I could be a NP... and one of my close friends (a MD) showed me the light. I couldn't be happier about it. Lot's of the money, about 1% of the bullsh*t you'll have. But go get your Dr. title. It'll be justified in your own mind, and that's all that matters to you.

Could you elaborate on this? I have been struggling between MD and PA (leaning more toward PA) and would like as much input as possible to make an informed descision. BTW, my mom and aunt are NP's and they couldn't be happier, so good luck in your training! 🙂

 

[PACtoDOC]

Lloyd, no one asked you to peek into my situation and try to psychoanalyze me. You have proven my point by agreeing that NP education stinks. Explain how you interpreted my decision to go back to med school through this thread. You are grasping at straws. I went back to med school because it was my decision. I am simply in that 5% or so of PA's that is not happy as a PA. But, that doesn't change the fact that I believe PA education to be far superior to NP's. Its just that now that I am leaving the PA profession, behind, I think it is time that someone be willing to mention this issue and not be worried about pissing off all the NP's. The reality is that NP's are where they are not because they are good clinicians, but more because they have excellent lobby power. Hands down, they know how to schmooze a legislature. But, the public has generally no idea what they are getting into if they allow their healthcare to be provided by an NP who is one of those NP's who thinks they don't need physician backup. NP's have a niche market but they should never be independent. It was not a smart move by the NP profession to try and cut the ties to the medical world by stating that they are independent. First of all, many states don't allow it anyway, and still require physician oversight. By trying to be independent, they have only pissed off the physicians for whom they generally work, and they have cornered themselves into a lower paying market than PA's. I am not saying you will not make an excellent clinician Lloyd, because you likely will. But all professionals need to have a minimum set of standards that make them capable of providing safe healthcare to patients upon graduation. Of all providers, NP's to me stand out as being the least capable at graduation, and have to learn the ropes for many years because of their subpar education. There are excellent NP's, as I will not dispute, but I am not going to spend the time to look for one when I know that most any PA will have been through more rigorous training. Its a matter of common sense to me, although we don't have to agree.

 

[DrQuinn]

For the scoreboard, I agree with PACtoDOC, wholeheartedly. He is giving some good information, and all who read these posts should heed his information.

Q

 

[deleted6669]

lloyd-some jobs are posted for pa's, some for np's, and some for both. as a grad of a dual degree program you could apply for any of them and also receive a better eduacation than np alone..

 

[lloydchristmas]

Originally posted by PACtoDOC
Lloyd, no one asked you to peek into my situation and try to psychoanalyze me. You have proven my point by agreeing that NP education stinks. Explain how you interpreted my decision to go back to med school through this thread. You are grasping at straws. I went back to med school because it was my decision. I am simply in that 5% or so of PA's that is not happy as a PA. But, that doesn't change the fact that I believe PA education to be far superior to NP's. Its just that now that I am leaving the PA profession, behind, I think it is time that someone be willing to mention this issue and not be worried about pissing off all the NP's. The reality is that NP's are where they are not because they are good clinicians, but more because they have excellent lobby power. Hands down, they know how to schmooze a legislature. But, the public has generally no idea what they are getting into if they allow their healthcare to be provided by an NP who is one of those NP's who thinks they don't need physician backup. NP's have a niche market but they should never be independent. It was not a smart move by the NP profession to try and cut the ties to the medical world by stating that they are independent. First of all, many states don't allow it anyway, and still require physician oversight. By trying to be independent, they have only pissed off the physicians for whom they generally work, and they have cornered themselves into a lower paying market than PA's. I am not saying you will not make an excellent clinician Lloyd, because you likely will. But all professionals need to have a minimum set of standards that make them capable of providing safe healthcare to patients upon graduation. Of all providers, NP's to me stand out as being the least capable at graduation, and have to learn the ropes for many years because of their subpar education. There are excellent NP's, as I will not dispute, but I am not going to spend the time to look for one when I know that most any PA will have been through more rigorous training. Its a matter of common sense to me, although we don't have to agree.

I think we probably agree more than we're letting each other know. I do agree that PAs get better education (although I'll have a better insight in a couple of years). But, you're also discounting all the years of RN experience and RN training. Yes, most of RN work on most floors has nothing to do with medicine. However, there are many situations where the RN must learn the medicine in what they're doing. I expect you to downplay NPs and say PAs are better. Of course you'll say that, because you are a PA. It's a biased opinion, no matter how you look at it. But, I have a bachelor's in nursing (2 years of nursing training with clinicals), and will have 2 years of ER experience and 2 years of full time NP training with a Master's in Nursing. Saying that I won't be comparable to a new PA grad after that is just insane. My 6 years clinical experience compared to the 2 years of PA school. If anyone wants to go against me straight out of PA school when I'm done with NP school, more power to ya.

 

[deleted6669]

Lloyd-sounds like you will make a great NP with your prior background. I think what matt was trying to say is that the typical PA has more health care experience before school than the typical NP. most pa programs require several years of experience at the level of medic, rn, or resp. therapist while it is possible to transition into many np programs directly from nursing school or with less than 2 years as a floor nurse. for instance I had 5 years as an ER tech and 5 years as a paramedic before pa school. best regards-emed

 

[lloydchristmas]

Originally posted by emedpa
Lloyd-sounds like you will make a great NP with your prior background. I think what matt was trying to say is that the typical PA has more health care experience before school than the typical NP. most pa programs require several years of experience at the level of medic, rn, or resp. therapist while it is possible to transition into many np programs directly from nursing school or with less than 2 years as a floor nurse. for instance I had 5 years as an ER tech and 5 years as a paramedic before pa school. best regards-emed

That may be... but the same thing goes for a doctor who has 10 years as a paramedic before med school compared to a doctor who has only med school experience. Of course there are individual differences between applicants, but saying "I'll never hire a NP because of the NP school" is just plain dumb, especially when he said himself that NPs and PAs are "probably comparable after 5 years of experience". Sounds like we're just chasing our tails here.

Good luck in whatever you all do. We're all different, and if we weren't, it'd be a boring world we live in.

 

[PACtoDOC]

Okay LLoyd, I'll hire you!!! I agree that medical experience is an incredible asset for any career as a provider of medical care (NP, PA, DO/MD), but it is not EVER a replacement for an education. You might be Johnny Gage in your former life, but that will only get you so far if you don't have the basics. And my point was that NP school doesn't seem to have the basics covered very well. There is a huge difference between the medical model and the nursing model of education, completely aside from the time difference (2000 hour difference in the clinical years for NP vs. PA). I have rarely if ever seen an NP student on call at 3:00 AM in the ICU or on the helo pad with me when I was a student. I always saw them in the clinics writing 6 page notes that looked like they were out of some cookbook of medicine. I am going to shut up though, because I don't want to offend anyone and have to have emedpa come bail me out once again! Lloyd, all I can tell you is that I hope you push yourself the extra mile to learn medicine for real during your clinical training, because otherwise no one will. Good luck.

 

[lloydchristmas]

Originally posted by PACtoDOC
Okay LLoyd, I'll hire you!!! I agree that medical experience is an incredible asset for any career as a provider of medical care (NP, PA, DO/MD), but it is not EVER a replacement for an education. You might be Johnny Gage in your former life, but that will only get you so far if you don't have the basics. And my point was that NP school doesn't seem to have the basics covered very well. There is a huge difference between the medical model and the nursing model of education, completely aside from the time difference (2000 hour difference in the clinical years for NP vs. PA). I have rarely if ever seen an NP student on call at 3:00 AM in the ICU or on the helo pad with me when I was a student. I always saw them in the clinics writing 6 page notes that looked like they were out of some cookbook of medicine. I am going to shut up though, because I don't want to offend anyone and have to have emedpa come bail me out once again! Lloyd, all I can tell you is that I hope you push yourself the extra mile to learn medicine for real during your clinical training, because otherwise no one will. Good luck.

Finally... SOLD!!! Seriously though... I'm looking to get some good info from NP school, but I'm depending on myself and my friend (MD) to get my real education to be a great NP. I agree, the nursing model and medical model are totally different (and I may be crucified for saying this, but the nursing model is total BS). On a letter of recommendation from one of my BSN professors, it had a place to list strengths and weaknesses. She wrote only one weakness: uses medical model instead of nursing model. Now see! We've been arguing over nothing this entire time!! LOL

How do you know so much about the NP corriculum? Have you looked into it? When I'm through with NP school, I will have had Anatomy/Physiology, Microbiology, Pathophysiology, Advanced Pathophysiology, Psychology, Pharmacology, Human Biology, Advanced Human Biology... not to mention all the "nurse" classes that do have healthcare and some medicine in them. So I'd say the training lays a pretty damn solid foundation. I haven't looked at a PA curriculum, and maybe that's where you have me on this. But, looking at all the healthcare related classes I have and have to go, I can't imagine having much more of a "foundation".

 

[apellous]

PACtoDOC

"Sorry if you are offended by the truth Lloyd, but I am not here to help you rationalize your decision to become an NP. The bottom line is that NP's have laughable clinical training in their clinical phase. Many only require 500 hours and back up their requirment by saying that nurses have all that time served as an RN. Serving as an RN is no replacment for clinical time as a provider. Nurses are not taught to interpret or diagnose disease. Your statement that health care providers are made on the job is also weak. So then why do physicians go to 4 years of medical school? We should just give them their title in advance and let them learn afterward right? The fact is, all other providers that have the ability to prescribe dangerous drugs, and treat patients, have the ability to do so the day they graduate. If you think 500 hours of clinical training makes an NP ready to treat patients you are wrong. Yes, as you say, NP's have the ability to read on their own as students or even grow in their "clinical" expertise as time goes by. But, they will always have a fundamental lack of understanding of pathophysiology and mechanisms of disease because their education stinks overall. You said it yourself. I said I would never work with an NP as a physician, and this is my right. If that offends you then chalk this response up as another you don't like provided by me. I am sure we will agree on something again later."


How do PA's obtain the understanding of pathophysiology?

I am medical student and my school has a PA program in which they do not take any pathology. Presumably they will learn everything they need to understand pathophysiology during there clinical years. Doesn't really seem to be enough to understand the concepts and how they are interrelated if you are only seeing it in clinic without understand the specific Dx process

O yeah and those dangerous drug that PAs can also prescribe for the pathologically condition they really dont know much outside of clinicals. I am a liitle curious how much they know about them when at my school they only have like 30-40 hours of lectures on Pharm and we have 3X that amount .


I am not trying to bash any particular midlevel provider here b/c God know after four years of med school I will still be real Green and need help. It is a life-long learning process for all who enter the field of medicine and whether your a PA NP or MD/DO we will all continue to learn

 

[PACtoDOC]

A PA program is not able to receive accreditation without a pathology course of some kind. They also can't with only 20-30 hours of pharmacology. Sounds like your PA program needs to be reported, or you are just incorrect. I suggest you check into it a bit more, because that is just not plausible.

 

[apellous]

I asked the PA students and they said they don't.

Also 40hours of Pharm?


Makes you wonder if the education uniform thoughout the country. It sure is a bit questionable

 

[deleted6669]

my pharm course at hahnemann/drexel was a year long taught by the same folks who teach the md course. we also had a fairly intense pathophys course in addition to a year of a and p, etc

 

[heart1st]

....at a time.
So, either you work as a PA or as an NP -- you can't work
under both scopes of practice simultaneously. I read that somewhere, I think on the Stanford program site. (Which is actually the Stanford-Foothill PA program -- I'm attending Foothill CC right now).

So...not sure what getting dual certification does for you...unless you want to have PA training but be an NP... think about what happens a few years down the road...if you start working as an NP, you will probably continue as NP, you probably are not going to start working as a PA after working as an NP for a few years -- or vice versa for PA.

heart

 

[deleted6669]

my point was that you could apply to more jobs because some jobs are posted for pa's only and some for np's only. yes, you can only function under 1 license at 1 place at a time, however you could work 1 pa job at site#1 and another np job across town at site #2 at the same time. I have a friend who does this and it works well for him.

 

[patriot_missile]

Hey what do you think of the 4 year bachelor's PA program? Such as at StJohnsU in NY? I mean if you are set on being a mid-level, then why waste 2 years for the MA, while you could be making $200k during that time?

Also, if you just do this bachelor's program, can you then go straight into a surgical pa residensy?

 

[cecilia]

12R34Y,

What has your friend told you about cardiothoracic surgery? Positive points, negative points, overall....what has been his experience? I am trying to see what field to get into after I graduate PA school. Thanks,

-Cecilia

 

[12R34Y]

Cecilia,

My former medical director of the ambulance service I worked for used to be a PA back in the late 70's. He worked for a cardiothoracic group and did "TONS" of bypass assists and his job was usually to harvest the saphenous vein from the leg.

that's all i know of his job back then.

later

 

[deleted6669]

fyi- cardiothoracic surgery pa's make great money, often> 80k/yr to start but at most places they get worked like dogs. a friend of mine working ct did 60-80 hrs/week + call. he also had to transport organs . for instance they could call him in the middle of the night and have this converstaion; " there is a heart waiting at the airport in kentucky, there is a ticket waiting for you at the gate. go get it. then when you get back here scrub in for the 6 hr procedure and make sure you still do your am rounds and clinic". brutal.....he lasted only 1 year. this was at a major academic medical center.

 

[Febrifuge]

I'm hoping to stoke the fires of this thread -- though NOT in a controversial way 😉 -- in order to revisit the question of PA vs. MD/DO. I'm glad to hear from the posters of yestermonth, and anyone new who has some perspective and/or advice.

Here's the deal: with luck and some hard studying, I'll be an EMT-B in a little over a month. My plan, as far as I can see, is to start looking for employment in entry-level medicine, ideally as an ER Tech. Since the BA I have is appallingly short on the sciences (god bless the arts), and I have no proven history of academic excellence with a heavy credit-load, I've decided I need a premed post-bac, or something like one.

And then, with the prereqs done... I jump off one cliff or other. Which one is hard to say at this point.

I know the nursing model does not excite me. I've got it at least narrowed to PA or doc. In trying to discern what I need to be when I grow up, I've attempted to identify traits that would lend themselves to success and happiness as one or the other. Be the best I can be, you know? But I'm falling into a gray zone.

I'm fairly sure I have more to offer a primary care field (and vice versa) than a hardcore specialty, so that's no help. Family practice is great for either. I know I like autonomy, and I can be a good leader, but in the right setting, I can be supervised without necessarily feeling stifled. My demeanor and bearing are confident and laid-back. I don't mind stress too much. I'm good with people. I have good recall for stupid details, and explain things well.

So I can't say I strike myself, or the medical professionals I've asked, as a clear-cut doc or a clear-cut PA, personality-wise, skills-wise, or goals-wise. Obviously once I pick a path, the pros and cons are going to manifest themselves, but I would HATE to feel as though I chose the wrong fork in the road. I'm already 33, fer crying out loud... so for example, following emedpa's road and doing PA school, then going back for DO/MD, seems (from the perspective of here) like it might kill me. 😉

I guess my real question is, how does one even sort this stuff out, anyway? Assuming my "find the ideal work situation for your personal characteristics" approach is valid, what is it that separates PAs from docs, anyway? If that's not the right way to investigate, then does anybody know a magic-bullet question, the answer to which will reveal all? Or am I stuck with nothing but hard work and tireless research to guide me? Thanks to one and all for observations and ideas.

 

[cecilia]

Hi, I will be 33 in sept. so I can relate. Several years ago, I turned down med school because of the circumstances around me. One of the reasons being that it had been my experience that MD's do not have a life. (I have several MD's in my family and also worked for a family practitioner for 4 years as a medical assistant) Some of my own doctors are either not married. Some I have met become very stressed, some have the need of becoming a better businessman than doctor because of all the costs of becoming and practicing as an MD. When I asked my OBGyn why he and his wife did not have kids...he answered we do not have time for kids. I have also met a few med school students that were so involved in school (I know it is a hard curriculum to keep up with) that they were sociallly inept for everything else. I did not want to be like that.
At this point, the only positives I see about becoming an MD is that you are more independent, have autonomy and recognition.
All I want is to be able to practice medicine and help my patients get better and be able to be a mom, a wife, a daughter, and have time for myself and my friends too.
You have to think what your priorities are and go from there.
Hope that helps a bit.

 

[angelic02]

Originally posted by emedpa
Llloyd-have you considered doing a dual degree program pa/np. there are a few out there and they are all taught at least to the minimum pa standard but if you go in as an rn you are eligible for both pa/np boards when you are done. the 2 that I know of off hand are uc davis and stanford. just a thought-e

How long are these dual pa/np programs? Do you have any sources where other people may obtain information about these?
I'm not really interested in attending any of them, but others might be, which is why I have written this post.

 

[deleted6669]

as far as I know there are only 2 programs, both in california, at u.c. davis and stanford. they are the standard 2 year programs but to get both pa and np certs you have to be an rn going in, otherwise the programs grants a pa cert only. I know a few folks who have done this and it certainly opens up the job market a bit as you can apply to either or both types of positions.

 

[Febrifuge]

Originally posted by cecilia
Hi, I will be 33 in sept. so I can relate. Several years ago, I turned down med school because of the circumstances around me. One of the reasons being that it had been my experience that MD's do not have a life... some have the need of becoming a better businessman than doctor because of all the costs of becoming and practicing as an MD... All I want is to be able to practice medicine and help my patients get better and be able to be a mom, a wife, a daughter, and have time for myself and my friends too.

You have to think what your priorities are and go from there.
Hope that helps a bit.

It does; thanks a lot. I guess for me, since I'm not excited about being a small business owner and I just want to take care of patients (maybe in family med, maybe in emergency), it might not matter a whole lot. I can see some benefits to being a PA, and not having to bear all the weight of the responsibility, at least from a financial and malpractice angle.

I should try to snag some of the PAs in the ED where I volunteer. Buy them coffee, get them to talk to me about what they did and how they decided.

I heard a tongue-in-cheek remark that being a PA is a little like being a perpetual resident, at least in a hospital setting. Would you say that's accurate in some ways?

 

[shygirl23]

So after you became a PA, and if you decided to go med school..do you have to start all over? like take all pre med courses and MCAT?....I thought pre PA courses were same as pre med....
so how can you become MD after PA?
😕

 

[Febrifuge]

bump.

Most recently on the table was my wondering out loud about the context of PA's practicing in a hospital setting. Was my source - who was really only half-serious - indicating a vein of truth when she said PA's are (functionally) a lot like perpetual residents?

 

[lalee]

The pre-reqs aren't the same. I decided after completing my pre-reqs for medschool to apply to PA school instead and found that I needed quite a few more classes. Unfortunately, some of the classes I had already taken as pre-reqs for medschool weren't required for PA school!
I'm sure you already know this, but MD/DO pre-reqs are usually:
1yr gen chem with lab
1yr o-chem with lab
1 yr physics with lab
1 yr bioloby with lab

The PA program I'm applying to requires:
1 yr gen chem
o-chem 1
microbiology
genetics
biochem
1yr A&P

I could have done without a year of physics! Oh well...I guess I "more rounded" now!
I am not aware of any MD/DO program that would "credit" you for your PA education. Pretty much if you want to apply to medschool after becoming a PA, you need to fulfill all the requirements just like everyone else. Yea...the MCAT, pre-reqs, etc. However, if you've taken the pre-reqs for a PA program, then you should be OK...might need 1 or 2 more classes (physics .😡 )

 

[cecilia]

There are a couple of med schools in the caribbean that will give you credit for PA school so that their program is shortened to 2 years. But I do not know how good they are. They say that their graduates do just fine and are able to pass all the exams, etc...

 

[healthydawg]

ok, i'm usually a lurker on this site. i think my last post was...i can't remember.

anyway, this is an interesting thread and i just can't resist the urge to post. so here's my take on the whole damn thing.

i can't help but feel like what's been lost in this thread, and in the countless other similar threads that have gone up over the years, AND the dozens of conversations i've had about this subject over the years is context. (was that a run-on sentence?) anyway, the context here is the study of MEDICINE and THE BASIC SCIENCES.

too often, i hear PAs, NPs, RNs, PTs, PsyDs, PharmDs, EMTs, OTs, premeds, etc., go on and on about who has the better lifestyle, who has more practice rights, who SHOULD have more practice rights, who has a better education, who makes more money and all the rest. docs (like me), do it too although i think a bit less. anyway, i think the basic question here is really one about what level and what type of care you want to be able to provide your patient.

soooooo, if you believe in the western medical model, which is based in the application of western medical sciences, the question really becomes one of what track gives you the level of training to learn and apply those sciences best for your patient. know that i'm talking AS A WHOLE here...not one aspect of one science. (ie., i will NEVER know as much about viruses as a PhD in virology does.)

now, if you prefer another medical model, there are other routes available for you. call me when your patient's gall bladder is about to explode.

anyway, to bring it back to this thread, i think the bottom line is that each individual needs to decide how far they need to go to provide the level of care they want to provide. if you think you'll be happy providing mid-level care, go the NP or PA route. you will care for people, you will make a difference in their lives, and you will have a nice lifestyle. the farm reps will take you out to dinner and if you're lucky, the occasional illicit golf outing. if you're good, you will stop worrying about all of that crap and will start worrying about doing the best for your patients. if you're good, your patients will love you and your docs will love you too. if you're not, people will die. regardless, please never believe you will have the same level of training in science or even in patient care and management as most (but not all) docs do. that's hubris and hubris is dangerous for your patients. you won't have the same level of training...and you REALLY won't understand that until you go to med school and become a doc. (ask your PA/NP friends who've done it.) after all, there is a reason PAs/NPs have restricted practice rights.

if you decide being a mid level is not enough for you then go to med school. sorry, it will be hell. long hours, enormous personal sacrifice, hard on your family...sh*tty lifestyle. you won't like a lot of your colleagues. you'll get your lifestyle someday but put that out of your mind for a decade because you have a lot of work to do. along the way, pray that you get some good science profs, interns, residents, attendings, and allied health folks who are willing to teach you something. and get ready to do a lot of learning on your own...you can never learn enough. in the end you'll come out of it better educated in the basics. and, if your hubris is subsiding, you will begin to realize just how incomplete your knowledge base is and how much further you need to go. AND you will smile at all the PAs, NPs, premeds, etc., etc., who wonder about lifestyle, level of training, and how many prescriptions for dulcolax they can write because you will start to see how much there more there is to caring for a human being.

BUT, if you graduate med school, never believe you have the same level of understanding as your intern. you won't. (hubris again.) and you won't understand that until you become an intern. likewise, the same holds true for the intern and the resident, the resident and the attending, and yes, the internist versus the surgeon on a CABG candidate or the surgeon versus the internist on IBD.

and just remember, none of us will know viruses the way the PhD in virology does. they get to smile at us!

ok, my rant is over. so with that, i return to the shadows.

 

[Febrifuge]

Thanks for de-lurking, Dr. Dawg. I think you've re-introduced something important and helpful here.

Let me take the floor for a second and put it to you thusly: I'm 33, and finally figured out what I'm for. I do want to "help people," and more specifically, I know I want to practice medicine, and I seem to have what it takes to be good at it.

But being a med student? That's another thing entirely. I worry I'm too old/ too stubborn/ too worldly to get my jagged edges through that machinery without considerable pain (to myself, and maybe to the machinery as well). I don't particularly care if I drive a Porsche or spend a month in the Caymans every year or two. I just want to do primary-type care, and eventually become known as a really excellent medical professional.

So, my dilemma is PA vs. MD or DO. Since the pre-reqs aren't as similar as I'd thought, some attention should be paid now. Your question is a good one; the level of care I want to provide certainly doesn't look like it's specialty care (though I might change my mind down the road). You can bet I'll have no problems referring patients to colleagues who know more than I do, and I don't plan to forget there will always be plenty of those.

I don't mind being part of a team, so long as I respect those I work with, and I don't need to be the boss (though I might change my mind down the road). I'm not interested in running a small business.

But, shoot, what if things evolve, and the level of care I'm able to provide per my scope of practice is no longer enough to meet the level I'd like to provide? I guess it's a question of what's worse: enduring the grinding marathon of med school and then doing a nicely-rounded family practice with lots of variety -- which might mean a touch of "over-schooling..." or doing a PA program and then frequently wishing I'd gone all the way?

This may be one of those questions with no good answer... anybody know the best way to even look at the question in the first place?

 

[hreiss]

Fabrifuge, I too am 32 years old. I had a job working for the government doing environmental regulatory work. I didn't like what I was doing and wanted to go back to school. I weighted the options. For me it was PA school or DO school. I had reasonable grades, a decent MCAT and all the extracuricular crap. I tossed it around quite a bit. My wife and I discussed it several times. She wasn't a whole lot of help though. Pretty much said which ever you prefer. I thought about why I wanted to go back to school. I wanted to help people and still make a reasonable living. I weighted it out. The time commitment, costs, the salary, and job satisfaction. I thought about the what if I become a PA and regret not being a DO. Could I live with someone else having the ultimate responsibility, always working for someone else. For me I decided I wanted to have more of a life. I didn't want to be starting over again at 40. So, I am now in my second year of PA school and I love it. The best advise is to do what is right for you.

 

[timerick]

A lot of good input here.

I have always loved the jobs I've had where I was in an "executive assistant" role. I actually like the accountability and counsel that are built into the job. I enjoy working for someone I admire and making them even more successful.

I know you could possibly find that kind of job as an MD or DO, but with the PA, it's usually built right in.

To some people, like the NP's I have met, my preference for being second-fiddle makes no sense. They want to be the concertmaster. And meanwhile I can't relate to their demand for independence. ["You are unique, just like everyone else."]

Personally I don't want to be a Lone Ranger. (I'd rather be a Tonto... ?aunque parezca bien tonto!)

Best to all in the decision making, and in respecting others and working to make this a good team.