PA student seeking advice

[PAintraining]

Hi, everyone! First time posting here. I'm seeking advice on a big career switch I've recently been pondering (for the better part of most days, lately). I started PA school 3 months ago and am having some major doubts about the profession. Taking a step back, I'm 29 years old with an MPH, research experience, and some publications. I had a job in research but got bored, and decided that medicine would be a better fit for me.

I initially choose PA mainly because I didn't want to delay my career for 8 years of training. I also got the impression that "work-life balance" was easier to achieve as a PA. I'm not so sure of that anymore. I've read about lots of EM docs that get plenty of time away from work. Lastly, I wanted to own a nice house before age 40 (petty, I know, but still a factor in my mind). So, PA school seemed to be a better fit. Plus, the cost of PA school would be covered for me (long story) but medical school would not.

Now that I'm in PA school, I find myself questioning my decision. I fear that, as a PA, I will eventually hit a ceiling in terms of leadership and salary. I also worry that I will be bothered by the salary differential between me and my supervision physician. I recently learned that some PAs make 1/10 of what their supervising physicians (SPs) make (in ortho surgery, for example). I'm not saying that an ortho surgeon shouldn't make 900K. I'm just saying that, after a while, it might bother me that I'm making 1/10th the salary of my SP if we work the same hours.

If I decide to pursue med school, I've have to take the MCAT in a hurry (Sept is the last MCAT this year) or delay applying for another year, which is more likely since I'd need more than 1 month to study (so I would start Aug 2020 at age 31). I wish I had thought about all this earlier in the summer so I could have taken the MCAT over the summer. Oh well..here I am. I'm asking for advice because I'm terrible at making decisions and I value the perspective of others. So, thanks in advance for any help or advice.

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[pamac]

A good place to go to get advice is the PA forums. They are all PA, all the time there. Just google “pa forums”, and it s one of the first results. I find them to be overly optimistic, and are among the type A of their career field, but I think they will give you insights that would be helpful, because a lot of them are or have been in the same boat as you.


But in the meantime, let’s address why you feel that as a PA that you would deserve a salary that is near an orthopedic physician when the only reason a person walks or rolls through their door is to utilize their services of said physician? I get what you are saying if you are posing it in regard to something like primary care. However, folks like orthopedic docs are generating the money, you are just helping. The big money there comes in due to their talent and skills in surgery. If not for that, your incomes would be closer to 1:2 or more likely 1:3. In the case of the orthopedic surgeon, without the surgery side bringing in the dough, it might not even be profitable to have you around based on what you would be able to bill for. What you are doing is helping out with freeing up the physician or helping him in surgery so that he can be more productive with the big ticket items. Only then does it pay to have you around.


I don’t think you are out of line wanting to have a decent (or even a nice) house. But keep in mind that goal will remain elusive for quite some time under many scenarios that you might face as a physician. I personally don’t think the grass is greener in most cases, and especially since you are right there in the midst of PA school, having done what it takes to successfully get there (which is a feat in itself). You beat the odds by getting in, and there is a lucrative reward waiting for you at the end of the journey. The only questions you are facing right now are whether there is a more lucrative reward in the path not taken. I personally don’t think that’s a healthy mindset to have, because that alternate reality comes at a significant cost to you in terms of time, treasure, and effort, along with a much delayed reward. The time commitment for you to make the big money in medicine is like 8 or 9 years from this point, and that’s just until you finish training. That doesn’t factor in when you will have enough freedom to spend money without regard to having add to your debt. Once you get out of medical school and into a wealthy practice, you can obtain that beautiful house that you want, but it will be financed on top of your massive medical school tuition and living expenses that you already have taken out loans on. So are you really wealthy until your loans are paid off? I say no, but many businessmen say yes. My physician neighbor who has the big house and the nice vehicles is in debt up to his eyeballs after going to an expensive private medical school. He might never be in the position that I’m in with my spouse where we live debt free except for our home that will be paid off in 8 years (and that’s the plan for me as an RN without factoring the higher NP wages that come with the additional income that my advanced training commands). But my neighbor can easily keep enough cash flow to make keep creditors at bay, and will probably have even more money coming in as he becomes more established. So who is in better shape, the guy fishing from the pier, or the one that has a fishing trawler with a mortgage?... Probably the commercial fisherman. However, I think a better scenario would be like assuming I’m like the fisherman with a small boat that pays for things as he goes. There’s a million different analogies that you could pick from.


You say Pa school is covered... that makes it an even better value for you... so much better. If you decide you don’t like it once you get there, go to med school. You won't be that much farther behind in terms of time. But no, I definitely do not think that jumping out at this time is a good plan.

 

[pamac]

Ill go on and say more....

So you are 29. You will be roughly 38ish when you are out practicing as a physician if you go that route (and lets say you are an ER physician). You then will have a mountain of debt. The debt comes from not just school, but the life expenses that will fund the things that you do in your 30's that you won't want to miss out on.The money can be good, but I think you will find that your willingness to forgo things in your 30s will be less than when you were in your 20s. I personally know ER physicians who are struggling with finances, which blew me away when I learned that from them. Plus, I've worked in the ER as a nurse, and know what goes on there. I wouldn't be happy working as a physician there. I'll do a play on a Jim Gaffigan joke, and liken the atmosphere to what it would be like to work as an ER physician: What is it like to be an ER physician? Imagine drowning, and someone hands you another patient (that is likely a train wreck) to take care of. When you fix a problem, you don't get time to bask in glory, because there is someone else to see.

If I were in your shoes, and I gave up on PA school to chase medical school and a career as a physician, I think that I'd be disappointed about a lot of the things that I discovered about the medical career that I had to sacrifice so much for. Its a huge price to pay for the respect that you feel you will find as a physician. And after 8 or more years of training, I don't think I'd be the least bit interested in taking on any leadership role. I'd want to enjoy the fruits of my intense labor.

 

[Noisewater-TDX]

If I decide to pursue med school, I've have to take the MCAT in a hurry (Sept is the last MCAT this year) or delay applying for another year, which is more likely since I'd need more than 1 month to study (so I would start Aug 2020 at age 31). I wish I had thought about all this earlier in the summer so I could have taken the MCAT over the summer. Oh well..here I am. I'm asking for advice because I'm terrible at making decisions and I value the perspective of others. So, thanks in advance for any help or advice.

Don't rush the MCAT. You need 3 months at minimum. I was 29 when i started med school. Some people in my class are in there 40's. You need to dig deep and figure out what you want!