PA to MD

[iabell1611]

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Any physician assistants out there who are applying for, or attending medical school. I know there are some of you out there. I have been researching A TON to make the final decision whether or not to go to medical shcool. Please respond if you are out there. I need some advice/help. Thanks

 

[f_w]

Ask yourself. What is the motivation to go to medschool, what are you trying to achieve ?

-- If your motivation is financial, make a careful calculation how long it will take you to make up for:
4 years of total income loss + tuition + 3-6 years of a 50% income cut. Unless you make it into a high-income specialty, it will take awfully long to make up for this hole. There are plenty of specialty PAs these days that make an income comparable to a primary care physician.

-- If your motivation is: 'Gee, I really want to work independently without having someone else auditing my charts'. I am sure you have talked to physicians, one of the complaints many docs have these days is that your practice is so constrained by insurance and healthcare buerocracy, that the change from PA to MD might not make such big of a difference.

-- As you know, the scope of practice and the training are different. If for you, this difference is worth the investment of 8 years of your life, go for it.

 

[iabell1611]

Thank you for your input. My reasoning for looking into going into medical school are as follows:

My PA program was part of my undergrad training so I became a practicing PA at the age of 22. The following year after graduation I worked as a PA while obtaining my PA masters.
I have since worked in Anesthesiology in obstetrics and now orthopedic surgery. I loved OB, and anesthesia both of which are difficult for PA's to enter. There are few if any post grad PA residency programs for these specialties which could aid in "selling yourself" to employers unfamiliar with PA capabilities in these specialties.
After working for 3 years as a PA I am discouraged. I want to move back to New England where obtaining a job as PA in anesthesia and OB is extremely rare and I am bored with the role of basically being a 1st year resident in orthopedics surgery. Currently we have no residents and the PA's pretty much run much of the surgery services including 1st assisting in the OR, rounds on the floor, ER consults, etc. There is not much growth available for PA's in my eyes and I am only 25.
Had I known what I do now about the healthcare industry I feel I would have just taken the med school route all along.
Because my PA degree was earned as part of undergrad (it was all crammed in including summer sessions and no electives available) I am missing a few prerequisite classes for med school such as organic chemistry II. Unfortunately, from what I understand clinical experience in a field such as ortho surgery as a PA which encompasses many departments of the hospital does not give PA's any advanced standing when applying to medical school. I believe I would still have to go back and fulfill the prereq courses and take the MCAT. Anyone know differently?

 

[f_w]

I believe I would still have to go back and fulfill the prereq courses and take the MCAT.

I believe that this is correct. I don't think there is any advanced standing for PAs.

You are young, and it sounds like you have your priorities right. I don't know how long it would take you to get into school, probably more than a year, but still you would be 27 when you enter, not terribly old to start a medical career if you ask me.

Do you have a specialty in mind ?

 

[iabell1611]

🙂 I'm thinking anesthesia at this point. But you never know. The time it will take to actually get accepted, the pre reqs and MCAT makes me wish I had started looking into this sooner. That's where the appeal to the Caribbean schools named in the PA newletters came in. The school of Health Sciences Antigua was one that did not require MCAT etc. But I have done some research and read that these schools are questionable and it would probably be "safer" to go to a US school.

 

[f_w]

Stay away from caribbean schools that offer you advanced standing. Some medical boards specifically check whether you where given advanced standing and if you did they won't accept your degree. Your best bet is to get into a US MD school, if that doesn't work DO, if that doesn't work you might want to look at other options like Ireland and Australia. As a last resort, there are a couple of half way reputable commercial schools in the caribbean. Ross, St Georges and AUC are the ones program directors at least recognize by name.

Anesthesia is a good field, and it seems like you had some exposure to it and have an idea what it entails. Don't let anyone tell you that A. Anesthesia will become obsolete because the CRNAs will take over everything B. As a non-traditional student you won't have a shot to get into it anyway.

 

[krust3]

you're young. go for it.

i'll be 27 when i start med school at SABA (carib school) in the fall.

got my M.S., PA in 2003. looking back, i wish i would've gone straight to med school, but i had thought i'd be satisfied PA. it's been a great experience. the break from school has been nice, and i'll be very well prepared for med school given the similarity of training and education.

PM me is you want. i don't cruise this forum as much as the others.

 

[iabell1611]

Wow. I finished my BS of PA in 2003 and worked for a year while getting my PA masters which i completed in 2004. DId you have to go back and take any additional pre reqs? And did you have to take the MCAT? Let me know..thanks. I too wish I had just gone to med shcool but I would not have come to that conclusion had I not done the PA thing first. When did you start applying to schools and how long of a process should I expect?

 

[krust3]

yeah i took biochem in place of org chem II.


the mcat is the major hurdle. the longer you are from undergrad the tougher it gets. it's been like 8 years since i had general chem 👎

 

[iabell1611]

So the courses that are prereqs for med school are not really set in stone? I wasn't aware that I could substitute bio chem for organic chem II etc.

 

[krust3]

not all schools allow this. you'll have to check with the schools you're interested in. pick up an MSAR book for the facts.

 

[preludexl]

I agree with the posters here. My boss the PA actually told me I should go into PA then get into med school. "There's a lot of PAs who do this he says" Thats what he would've done. Instead he stopped practicing as a PA and went into the govt sector in environmental health. Most schools are set in stone with the premed prerequisites. You should apply to DO school if you just want to be a medical doctor and not care about the 2 letters that denote your profession. 3 of my siblings are allopaths, UCSD med school, and 2 at U Pitt Med. None of them really cares about the MD or DO connotation. You are both gonna have to work together as equals anyway.

 

[supa]

Well I'm a PA who just got accepted to a US medical school last week, and 4 interviews left to go. Basically I decided to go to med schol during my clerkships, where I saw PAs presenting treatment plans to MDs and these docs making suggestions and changes. Even as I worked in internal medicine for 2 years I found myself unsatisfied with my level of responsibility and authority.
I was in worse shape than you because I had to take Gen chem 1+2 cuz I took Chem for health sciences. Then Org 1+2, and Physics 1+2. So it took me a while to complete my prereqs and then studying for MCAT while working 50 hours/week is no joke. But if it's what you want...go for it. I cannot imagine being a PA for 10+ years and looking back wid regret about not going. I'm excited not just becuz I'm gonna be a doc, but I'm actually looking forward to 7 years of intense learning. School rocks!!!!!.
Just go for it man, and good luck!

 

[iabell1611]

thanks!. I know it probably was a pain in the ass but it's encouraging to see that someone was actually WORSE off than I am in the prereq dept. So...a question for you. Do you think that if I take the classes in the summer and next fall (prereqs) and the MCAT lets say in August...that I will have enough time to be accepted and begin med school in August of 2007?

 

[supa]

thanks!. I know it probably was a pain in the ass but it's encouraging to see that someone was actually WORSE off than I am in the prereq dept. So...a question for you. Do you think that if I take the classes in the summer and next fall (prereqs) and the MCAT lets say in August...that I will have enough time to be accepted and begin med school in August of 2007?

Sure I don't see why not. As long as you finish your prereqs prior to matriculation I think most schools would still accept you. But call the individual schools to make sure

 

[krust3]

so supa, were schools clamoring to get you or what!? i see you've already got your acceptance, do you know yet if you'll take that offer or go somewhere else?

i figured out i should just be a doc on day one of PA school when i walked into anatomy- with the med students! i kicked myself for two years while getting my PA for having thought med school was so unobtainable and only for rhodes scholars.

good luck. congrats.

 

[supa]

so supa, were schools clamoring to get you or what!? i see you've already got your acceptance, do you know yet if you'll take that offer or go somewhere else?

i figured out i should just be a doc on day one of PA school when i walked into anatomy- with the med students! i kicked myself for two years while getting my PA for having thought med school was so unobtainable and only for rhodes scholars.

good luck. congrats.

Wel I took August MCAT, my AMCAS wasn't complete until Nov 30th thanks to my school taking their time sending my transcript. My secondaries were sent mid December and I still got 5 interviews out of the process. Only been on 1 interview so far, and let me be honest...THEY LOVED ME.
It was 2 separate interviews and I spent most of the time talking about what I do as a PA, and they were both very impressed with my knowledge and commitment to medicine. One of them even went as far as to say that the school *needs* a student like me who had such significant clinical experience in order to mentor the other students.
So I think contrary to what I've been told throughout the process, being a PA was the strongest part of my aplication, and I think it was the strongest determining factor in my admission. One interview down, one acceptance gained...4 more interviews to go!!! I encourage any PA who's thinking about med school to go for it, and bring your experience and knowledge to the table cuz I'm willing to bet it's better than what most science majors have to offer.

 

[krust3]

cool. 👍 congrats and good luck on your remaining interviews.

 

[wannabee1]

i am currently trying to decide whether to try for med school or pa school...i am in the process of getting my prereqs done (i have a BS and MS in kinesiology and am an athletic trainer). the complicated part is that my fiance just got into medical school and will be starting in august. that means we will double the loans with each of us not earning full time for at least 8 yrs. pa school seems more appealing for my life in that i do want to have a family (before i'm in my midt-thirties)...the thought of being out and making a full time salary in about 4 yrs (including prereqs and getting into pa school) is attractive for my life plans but there is a small part of me that still thinks i would be happier as a physician...i guess my question is mostly the satisfaction of being a pa compared to md/do as far as career advancement.

maybe it just comes down to me deciding career vs. family priorities...any thoughts/advice?

 

[tara14]

i am currently trying to decide whether to try for med school or pa school...i am in the process of getting my prereqs done (i have a BS and MS in kinesiology and am an athletic trainer). the complicated part is that my fiance just got into medical school and will be starting in august. that means we will double the loans with each of us not earning full time for at least 8 yrs. pa school seems more appealing for my life in that i do want to have a family (before i'm in my midt-thirties)...the thought of being out and making a full time salary in about 4 yrs (including prereqs and getting into pa school) is attractive for my life plans but there is a small part of me that still thinks i would be happier as a physician...i guess my question is mostly the satisfaction of being a pa compared to md/do as far as career advancement.

maybe it just comes down to me deciding career vs. family priorities...any thoughts/advice?

Wannabee1, I'm in a similar situation as you. I have been making the decision of career vs. family priorities. People keep telling me you can have both, but I don't know. My thing is that I'm going to be 27 when I start med school - 31 when I'm done and then 34/35 when I'm done with residency. I couldn't imagine trying to have a family during that time - plus all the financial burdens that I will be placing on my fiance during that time, and all the debt that I will be accruing and having to pay off. It's a lot to ask for him to support me for 8 years, and wait to start a family when I'm done. It's a very hard decision to make - but whichever way you choose make sure that you are comfortable with your decision and that you won't regret it later on. I've been thinking about not going to med school now and instead becoming a NP/PA. I have the same question as you - I worry that I will work as a PA or NP and not be satisfied or regret my decision not to become a MD/DO.

 

[MSc44]

just out of curiosity, if a PA goes to medical school but never becomes licensed as an MD can they still put Dr in front of their name..Since they do hold a doctorate of medicine degree.

I know of someone who was a PA went to a foreign medical school, was unable to pass step 1 of usmle but graduated and obtained his Doctor of Medicine degree.

in the office where he works he is called Dr

The names are as followed

John Doe, MD
Jane Doe, MD
Jeff Doe, DO
Dr. John Doe, RPAC, MS


I supose its ok since his credentials are stated and he does hold a DOCTORATE DEGREE (in medicine)

What do you guys think

 

[deleted6669]

nope- illegal to call yourself an md in this country if you haven't passed the usmle.I know folks in this situation.
it is also illegal to call yourself dr in a clinical situation if you are a pa,phd as it confuses pts into thinking you are an md.
I work with a pa who has an md from another country and never passed u.s. boards. he is very careful to represent himself only as a pa.

 

[f_w]

I know of someone who was a PA went to a foreign medical school, was unable to pass step 1 of usmle but graduated and obtained his Doctor of Medicine degree.

This joker is not the first one who came up with this idea. In some states law specifically limits the use of the title 'doctor' in a medical setting to someone holding a valid medical license or GME permit. In other areas, this has come up with complaints to the medboard and the PA licensing boards. Whenever it has come up, the requisite authorities have decided that buying an 'MD' at a title mill doesn't allow you to pass yourself off as 'doctor' when seing patients (this is mainly geared towards a well known caribbean 'medical school' which sells distance learning medical school diplomas to DCs and PAs knowingly well that they will never be able to pass the USMLEs or obtain a medical license with it).



As for the docs from other countries who go to PA school here: At times they work as PA within their ethnic community (e.g. cuban docs in south florida). Their patients know well that their PA was a doctor back home and will put even more trust in them than they would put into a 'real' US physician. Ethnic allegiance at times works in funny ways.

 

[femme13]

I guess I have been contemplating the same issues as some others in this forum. I am 24 now, completing my pre-reqs, planned on medical school but recently have been thinking that PA would be a better option.

My recent plan has been to get a PA because my fiancé is getting a degree for the next 4 years full time. I don't want to add the extra stress financially with having no stable income during that time. Then once he is finished maybe I can think about getting an MD or DO. That means that I will probably be in my 30s and there is also the question of when to start a family.

Now, I am just questioning whether I will be satisfied as a PA if I never do get the chance to go to medical school. Or should I just go right for medical school, bypassing PA? I understand that some have said here that PA is not a stepping stone to medical school but I would like to be in the health care field somehow.

I am deterred by the amount of paperwork and insurance involvement that a doctor has to deal with, but I would also like the depth of knowledge and independence of a doctor.

I am thinking the best thing to do now is take my pre-reqs until my fiancé is finished and then see where I am at in life and what can be done.

Anyone have any thoughts?

 

[MSc44]

I guess I have been contemplating the same issues as some others in this forum. I am 24 now, completing my pre-reqs, planned on medical school but recently have been thinking that PA would be a better option.

My recent plan has been to get a PA because my fiancé is getting a degree for the next 4 years full time. I don't want to add the extra stress financially with having no stable income during that time. Then once he is finished maybe I can think about getting an MD or DO. That means that I will probably be in my 30s and there is also the question of when to start a family.

Now, I am just questioning whether I will be satisfied as a PA if I never do get the chance to go to medical school. Or should I just go right for medical school, bypassing PA? I understand that some have said here that PA is not a stepping stone to medical school but I would like to be in the health care field somehow.

I am deterred by the amount of paperwork and insurance involvement that a doctor has to deal with, but I would also like the depth of knowledge and independence of a doctor.

I am thinking the best thing to do now is take my pre-reqs until my fiancé is finished and then see where I am at in life and what can be done.

Anyone have any thoughts?

Wish i did im in the same boat only im a 24 year old guy and finished my pre-reqs

 

[wannabee1]

i am glad to hear that i am not the only one in this situation....any of you current PAs that have had to make the choice? anyone feel like they wished they had done something differently when they were choosing to go to PA school vs. med school.

 

[iabell1611]

Well i'm the one who started the thread. I'm 25 and have been a PA for 3 years. I have been seriously contemplating going to medical school. I only wish i had made that decision earlier. But I honestly feel had I not been a PA i may have never come to that conclusion. I first wanted to be a PA to be able to work in medicine, do a lot like a doctor, and still be able to have a family etc and also without all that school. At 18 I couldn't imagine 12 more years of school. And I have to say I was somewhat lucky. My PA school was part of undergrad(junior and senior year) but fulltime (24 months) but then at 22 I graduated and was a PA. I have worked for 3 years and most recently in orthopedic surgery where the PA's pretty much run the in house ortho service with no in house attendings (there is always one on call to come in when needed) and we function pretty much like residents. A lot of responsibility and wonderful work for a PA. However...the areas of medicine that I am passionate about...enjoy...would be happy going to work every day doing ....are peds ER, OB and anesthesia. Unfortunately 3 areas of medicine where PA's are not "strong" or used widely. I also feel that being a PA at 22 making x amount of money and doing so much clinicially that at 30 it would be nice to feel like i had "grown" professionally. I feel like PA salaries cap quickly and you are an eternal resident. For that much responsibility to make more money i might as well go to med shcool and enter a field of medicine that i love. There are certain specialties taht make more money but i'm not interested in cardio. There are chief PA's and they are almost like a chief resident. But still then you can only do so much. So I looked into PA residency's for the three areas of medicine i'm interested in. There was one OB and one Peds. No anesthesia. So ok, maybe go to a residency and find a way to "sell" yourself and your abilities to those who may not know what a PA can do in the peds ER. But I then realized that as a PA you then have to battle the state and facility restrictions regarding PA practice.
So the fact that I love medicine and can't do what I want in medicine as a PA has made me very excited about medical school. MY only concern is family.

 

[wannabee1]

So the fact that I love medicine and can't do what I want in medicine as a PA has made me very excited about medical school. MY only concern is family.[/QUOTE]

Are you looking at starting a family soon? my problem is that i know im not looking to have kids today, but definitely in less than 10 years (i'll be 25 in 2wks) i think its hard because right now i feel like i should just advance my current position (as an AT) and pursue PA, i think planning beyond that may be getting ahead of myself.....

 

[iabell1611]

Thats what I mean. I am 25. I wouldn't be able to start med shcool until 2007 and I would almost be 27. I wish I was in med school right now because I am a PA want to go to med school and right now I have the time and no family. But do I want to put off starting a family until 34? I would be 34/35 when I finish residency. I know a lot of people who have had children during residency but do I want to do that and have someone else raise my child for a little while? I don't really know that now and I don't think I could. I mean i'm single with no husband, no kids. But I don't know how Il'l feel 2nd year into residency. So that's my hesitation.

 

[Joebird22]

Are there any future plans to have a PA to MD bridge program? I think it would be a great idea but what do y'all think????

 

[iabell1611]

From

 

[iabell1611]

From what I understand and from talking to people here and after doing a lot of research there are no such "bridge" programs. But one person did tell me that in his search and talking to DO schools...a few had been trying to work out a curriculum for that. They said that although PA school and medical school teach similar subjects in didactics...medical school goes into more detalil. So it would be hard to exempt a PA from classes. Personally I truly hoped for a program like taht when I first started thinking about going to medical school


If you think about it. We did 12 months of clinicals. WIth the 3rd and 4th year med students. The only thing different was the test our respectives schools gave us at end of rotation. medical students have that summer break. We did not. So we did 12 months of clinicals. They did 18. ONly 6 months different. We even had the same procedure books which had to be signed and completed for graduation. Also didactic. They did 18 months...we did 12. again 6 months different. I really really really wish it could be done. It should be able to be.

I know many medical students dont' like the idea that a PA could do that . But they have never been to PA school so they wouldn't really know. Also, most PA's who go to medical school have at least 3-5 years experience as PA clinically. Which like my job right now....we work and do the SAME work as the residents which is very beneficial and should hold some standing in completing medical school.

 

[Jengirl18]

Well, although there is no "advanced standing" for PAs, what I like is the fact that you can switch specialities without more schooling. NPs nor physicians are able to do this.

PA-S
c/o 2007

 

[corpsmanUP]

We did 12 months of clinicals. WIth the 3rd and 4th year med students. The only thing different was the test our respectives schools gave us at end of rotation. medical students have that summer break. We did not. So we did 12 months of clinicals. They did 18. ONly 6 months different. We even had the same procedure books which had to be signed and completed for graduation. Also didactic. They did 18 months...we did 12. again 6 months different.

I assure you that there are many more differences than simply 6+6=12 months of training. The real difference cannot be seen unless you have endured both curricula. Once you have studied for and taken the terribly stressful SHELF exams at the end of each rotation, you will understand. PA schools have no required exam at the end of a block other than whatever the school itself chooses to give. SHELF exams are mini board exams that require tons of study and stress. Each med student will endure a dozen of these during clinical years. Then there is the way that attendings view different types of students. Many times med students are required to be more accountable. Residents especially tend to expect more of their own. You can believe they don't, but until you've seen it from both sides you will just have to take my word for it..or not.

I do believe it would be very possible to have a bridge program but in reality I don't believe it could serve to eliminate any real time off the 4 years. Instead I believe it would just start by allowing PA's to test out of some courses and allow them the opportunity to work while in school. Then I think it could be modified to allow for a PA to perhaps complete medical school in 3 years total. There undoubtedly had to be an entire year for pathophysiology. There undoubtedly has to be a clinical year because all 50 states require one to serve in the official capacity as an MSIII in a US hospital for 12 months of clinicals. Then you have to have 4th year because it is the year that you have to go through all the garbage of residency interviews...etc..

I see only one year of shaved time in the end. And since no program is likely to create a completely different curriculum for a few PA's, its likely going to evolve as I said and there will be a "clep" format for PA's. I believe that most PA's would not "clep" out of much of the 1st or 2nd year because it is all the basics for the USMLE I. And without passing USMLE I, you can'tmove forward.


The bottom line is that PA and MD are 2 different professions practicing similarly. If you plan on using your PA to become a physician, don't plan on it helping you in any other way besides being one hec of a "jump start" and a cushion to protect you against the curve.

 

[quicksilver2]

I assure you that there are many more differences than simply 6+6=12 months of training. The real difference cannot be seen unless you have endured both curricula. Once you have studied for and taken the terribly stressful SHELF exams at the end of each rotation, you will understand. PA schools have no required exam at the end of a block other than whatever the school itself chooses to give. SHELF exams are mini board exams that require tons of study and stress. Each med student will endure a dozen of these during clinical years.

A dozen? Hmmm...my med school had us take six -- one at the end of each core clerkship. Oh, and one for pathology. They were stressful, but actually not much more than the end-of-rotation exams I had in PA school.

Then there is the way that attendings view different types of students. Many times med students are required to be more accountable. Residents especially tend to expect more of their own. You can believe they don't, but until you've seen it from both sides you will just have to take my word for it..or not.

Maybe. I can't say that as a PA student I was ever treated differently from medical students. Actually, towards the end of my clinical year, I was given _more_ responsibility because the feeling was "you'll be doing this 'for real' in just a few months, while they have another year to go."

I remember in my _first_ rotation in PA school the 3rd year resident giving me some fairly substantial tasks that the 2nd year resident should have done -- but that he wasn't doing. (There was some later intervention and remediation with this resident -- he had some issues.) This was even with plenty of medical students from the same institution as the resident around.

I see only one year of shaved time in the end. And since no program is likely to create a completely different curriculum for a few PA's, its likely going to evolve as I said and there will be a "clep" format for PA's. I believe that most PA's would not "clep" out of much of the 1st or 2nd year because it is all the basics for the USMLE I. And without passing USMLE I, you can'tmove forward.

I agree that most schools don't make it easy for _anyone_ to gain advanced standing. It's too bad, because the exams to "proficiency" out of basic sciences are often more difficult than what you need to pass the course. (at least in my limited experience with them.) I will say that when I took Step 1, my impression was that I would have been able to pass it based on my knowledge as a PA and perhaps a few months' worth of independent study using the usual Step 1 study resources that most students use. (Actually, same for Step 2, come to think of it.)

The bottom line is that PA and MD are 2 different professions practicing similarly. If you plan on using your PA to become a physician, don't plan on it helping you in any other way besides being one hec of a "jump start" and a cushion to protect you against the curve.

I'll agree with that. 🙂 I think the main issue is that there's not a substantial market for any school to bother creating an upgrade path. I would like to see one happen, less for the convenience factor but more to send a message that PA and MD training is not as different as some would like to think. It _is_ different, just not as radically different as I've seen argued in some places. I'll also say that in my experience, most PAs have a pretty good idea of what med school consists of, etc, but the majority of MDs still have no idea what goes into PA training, certification, licensure, etc. (In some fields, they barely know what a PA is.)

Oh, and before anyone starts asking, yes, I went to a US medical school. 🙂

 

[hospitalistpac]

I think about going to med school. The biggest deterrent is repeating rotations. I see the med students at my hospitals rounding on gyn pts at 5am, writing notes that no one will read. I did that already. I also did psych, fp, im, er, etc, etc. And yes we had tests at the end of every rotation that were stressful.
If a med school was to shave any time off, it should be from rotations.
My ideal med school: 20 months straight through didactic
12 months of fourth year type clerkships
Take step I, II along the way, then residency
I know it will never happen because of money. People pay to do third yeard rotatation, so why would they let someone not pay/not do it?

 

[corpsmanUP]

I think about going to med school. The biggest deterrent is repeating rotations. I see the med students at my hospitals rounding on gyn pts at 5am, writing notes that no one will read. I did that already. I also did psych, fp, im, er, etc, etc. And yes we had tests at the end of every rotation that were stressful.
If a med school was to shave any time off, it should be from rotations.
My ideal med school: 20 months straight through didactic
12 months of fourth year type clerkships
Take step I, II along the way, then residency
I know it will never happen because of money. People pay to do third yeard rotatation, so why would they let someone not pay/not do it?

What is slowly happening, at least at my school, is that the Dean and President who are big PA proponents are seeing how well the PA's are doing in med school. Unfortunately its not all that impressive. I think I can say with 99% certainty that of the PA's that graduated ahead of me, and those behind me, none other than myself have bothered to try real hard and thus I am the only one near the top of my class. That does not help the profession, but helps the individual PA. I have had a great deal of pride in med school...wanting to make sure that no young whipper snapper was able to blow me away when I had a ton of clinical and academic experience coming in. I mean lets face it, there is no better preparation on earth for med school than being a full time primary care PA for several years. Though it sucked, I was able with about 50% effort to keep myself in the 95-99%ile range for rank, boards, and evaluations. Most of the PA's I know in med school rarely if ever worry about doing well. They just want to get through. They probably put forth considerably less effort than myself and still pass.

As for your ideal med school...I think it is feasible but unfortunately unrealistic. I do believe that if you could custom build a curriculum for PA's to go through med school as efficiently as possible, it would be like this:

First semester: Histo completely, Pathophys...first half of Robbins Text
Second Semester: Histo Part II, 2nd half of Robbins + rapid A&P review

Then, take USMLE Step I
Now for the clinical year (this is where it gets tricky) The student should be required to take the USMLE I by the end of June after the first year. Then, electives aimed at obtaining residencies should be allowed for July, August, and September. Now between October and May, each student would need to repeat each core rotation for only 1 month and serve as an MSIII, not an MSIV (because everyone knows MS4's don't do squat!!). Interviews would need to be done during either a December or a January vacation month, the only vacation month of the entire 2 years. The PA's would then take Step II of the USMLE in Spring after their interviews and graduate with the respective class, thus shaving a total of 2 years off the curriculum.

You simply need a progressive Dean to be convinced that signing off on the education was equivilant. Because as long as you have a Dean who signs the form for NBME, you can test and graduate. Its the state medical boards that might give you a problem if they were to look into the curriculum and see that there was not a total of 4 years in the med student capacity. They probably would not even look though if you had a diploma.

As for USMLE...I just think the main hurdle is passing Step I. I believe once a PA has studied for and passed Step I, it would only take minimal studying to pass Step II. Step II for me was much easier than Step I and I have no doubt I could have passed it as a PA having never been to med school. I would not likely have passed Step I though without additional education.

Another hurdle would be PD's seeing your strange looking med school transcript and not understanding it come application time for residency. I think being a PA helped me 85% of the time in my applications for residency but I am quite certain my being a PA turned off some of the more prestigious programs. I think they felt I might know too much and those power hungry academics in places like that want to have all the cards of the deck in their hands.

Quicksilver...you are correct...not a dozen Shelf exams.

Basic Science Shelf
Medicine
Surgery
Psych
OBGYN
Peds
Family Medicine

Some schools I think take an NBME EM and neuro shelf as well.

I too found the Shelf exams rather easy but it was because I studied for them. I knew from studies that a 95-99% on the Shelfs would get in excess of 250-260 on Step II. And I wanted to do that well.

In the end, if you went straight through, in a program that had the resources to devote to this type of curriculum, I believe it could all be done in 4 semesters....so less than 21 months total.

The problem is that most major med schools now also have PA schools, and it serves no greater good to encourage these grads to want to go back and become physicians. I also believe a curriculum like this should require a PA to have 3-4 years of full time work under their belts prior to entering.

BTW...I believe that a program like this should require an entrance exam and waive the MCAT. The entrance exam should be something like 200 questions comprised of all aspects of basic anatomy, physiology, pharm, etc....and as the program becomes more competitive it moves from simply a passing score to one where the highest 10 grades for instance are admitted.

Maybe when I am Dean!!! 😉