PA vs. MD (Am I making the right choice?!)

[smartc00kie]

Hi all,

Thanks for the help I received in a previous thread. I have come back for more advice!

A little about me: I'm a junior who will be applying to colleges this summer and I'm trying to figure out exactly what I want to do. I have the option of a 5 year physician assistant program at University of Detroit Mercy, where I should be able to get a full ride based on my GPA and ACT, or I could go premed at UMichigan or other instate schools.

Originally I thought that I wanted to become a doctor, but soon realized that I would be 30 by the time I was actually out of residency! I know that it is a substantial investment of one's time, but I want to start a family and have a life!

My question is: Should I opt for the 5 year PA program?

I've had the opportunity to shadow a PA and the opportunity to shadow a doctor. I like both relatively equally, though for different reasons. A doctor is the main show and in charge. But a doctor has to fill out a million forms, worry about malpractice, be on call, and work longer hours (of course this varies, but this seems to be the general trend).

A PA on the other hand has the autonomy to diagnose patients, has more time with them, has less stress, doesn't have to worry about malpractice (to an extent), and has slightly less paperwork. But PAs get paid less and some patients are hesitant to be treated by a PA.

I am honestly not too concerned about the reimbursement aspect of the career, as I want to go into primary care and either way there is no money in primary care. I am really just interested in enriching patient's lives and actively counseling them, helping them to make sound medical decisions, and respecting their wishes. I either want to go into peds or geriatrics.

So what do the brilliant minds of SDN think? Should I opt for a life and an early graduation date but a lower salary? Or should I opt for the prestige but all the stress inherent in being a doctor?

Enlighten me!

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[BigRedBeta]

I think you have perfectly acceptable reasons to go to PA school.

What it really comes down to, I think for a lot of people is ego. There are some people (like myself) where not being the boss would bother them. But that is certainly not the case for everyone, and the positive benefits of less time and money invested in training, greater flexibility of specialization (since you don't need a residency), and better hours, makes PA a great option for a lot of people.

 

[Gallix23]

Well, there is a totally different way that you could look at things also.

Yes, you would essentially be sacrificing your 20s, but 30 is still young. Many physicians also have families, and they get to do rewarding work every day that's always changing and unique.

On the money side of things; when you DO have a family, you'd be working as a PA for less than 100,000 a year. It isn't bad, but it's not overly comfortable either. As an M.D, you'd have a nice cushy salary to go along with things. For example, my mother is an CCRN, and she works with Interventional Radiologists. One of them is in currently in Colorado for 3 weeks skiing with his family. They both get 15 weeks vacation time a year. That's a pretty sweet gig if you ask me.

I know every specialty isn't like that, but it's sort of a matter of going the short route and making <100,000 a year, or going the long road and coming out with a rewarding career and nice salary at the end.

 

[ZFanatic]

If you really want to be a doctor, then I'd go for it.

I've heard a lot of PA's and people that work in doctors offices that really regret not going for the gold and becoming an MD, and that it would've been worth the work to be the doctor rather than the guy who takes of casts and cleans up after.

If you're fine with being a PA then by all means go for it. We can always use more of things like PAs and nurses so it's certainly not a bad thing. I'm just saying a lot of them that I've talked to regret not at least trying to go to med school. On the other hand though, there are just as many (probably more) that are extremely happy with what they do. They get to basically be a doctor without all the responsibilities hanging over your head.

 

[Terpskins99]

I think you have perfectly acceptable reasons to go to PA school.

What it really comes down to, I think for a lot of people is ego. There are some people (like myself) where not being the boss would bother them. But that is certainly not the case for everyone, and the positive benefits of less time and money invested in training, greater flexibility of specialization (since you don't need a residency), and better hours, makes PA a great option for a lot of people.

I think if you are comfortable pursuing a primary care position (or a surgical assistant), then PA is a good option. But for me, I wanted the option to explore every area of medicine. I always felt that PA's were a little limited in this capacity.

I'd be lying if I said pay and prestige didn't have something to do with me going the doctor-route.

 

[bkz]

^^PAs can move laterally but I think you meant that there are (of course) many specialized areas of medicine which require training beyond the PA level (maybe PAs are first assisting or closing wounds on surgery but not always doing the entire procedure).

OP if you are just a junior in high school I think you should get the best grades you can and come back to this decision in 3 years, or whenever you have finished your sophomore year of college. Some of the differences between PA and MD come down to the level of responsibility one is comfortable with/prefers to work with, and I feel that is partly a function of maturity. Some of the fundamental lifestyle/responsibility differences are not something you may be able to completely assess while still in high school. Be sure to get the best grades you can so that you don't close any doors for yourself, and don't be afraid to take a break if you need to figure out your motivation (rather than slogging through it and getting many semesters of crappy grades, which for many is the most difficult part of their application to improve). And yea it is cliche but nothing worth having comes easily.
GOOD LUCK!

 

[Depakote]

If you aren't sure, I wouldn't commit to a track just because the option is available.

My rule of thumb is: if you're smart enough to get into an accelerated or joint degree program in HS, you are probably smart/dedicated enough to maintain that and get in out of undergrad.

These programs can be good if you absolutely know what you want to do, but if you aren't sure, you're locking into something you might have regrets about later if you change your mind when more information comes to light. There's no reason you HAVE to choose now. The program just happens to be available for those that already made the choice and wouldn't be happy with anything else.

 

[BigRedBeta]

I think if you are comfortable pursuing a primary care position (or a surgical assistant), then PA is a good option. But for me, I wanted the option to explore every area of medicine. I always felt that PA's were a little limited in this capacity.

I'd be lying if I said pay and prestige didn't have something to do with me going the doctor-route.

PA's move laterally all the time, PA's also can be very specialized. I have friends who are PA's in everything from Pediatric infectious disease to anesthesia to neurosurg. Is the anesthesia PA putting people out? Of course not, but she frequently intubates, places lines, and does more administrative stuff (which she enjoys). The PA in neurosurg often was the one who formulated all the care plans for that particular team because he was the one who got the page for consults. The surgeons were always in surgery (imagine that) so initial plans were all on him.

Pay is nice, but if you consider the lack of debt, the increased number of years earning market value for salary, the discrepency is not that bad (the debt in particular is a killer for most docs salaries). Most PA's, particularly those working in private practice can dictate a lot of control over their schedule in their contracts. They may not be making 6 figures, but they're usually also not working 80 or 100 weeks.

I agree with depakote on the issue of getting into accelerated/guaranteed programs.

 

[beckhunter116]

1st I hope you have spent some time or will spend some time browsing the PA forum. http://www.physicianassistantforum.com/forums/

As opposed to SDN it is all PA's so they have more information then the forum here I believe.

I think that some of your notions about PA may be faulty. PA's don't have more time with the patient, they can (and probably will) have on-call, and they can work as many hours as a physician. OF COURSE, this varies on the job you find. Are their 40 hour work weeks? Yes, but are you going to be able to get that job. Are their jobs with no call? Sure, but again you have to find these positions.

I don't know what you should do, but I would definitely advise looking at the PA forum and look at the threads there as they address alot of your thoughts. Good luck!

 

[EndangeredPasta]

Well, there is a totally different way that you could look at things also.

Yes, you would essentially be sacrificing your 20s, but 30 is still young. Many physicians also have families, and they get to do rewarding work every day that's always changing and unique.

On the money side of things; when you DO have a family, you'd be working as a PA for less than 100,000 a year. It isn't bad, but it's not overly comfortable either. As an M.D, you'd have a nice cushy salary to go along with things. For example, my mother is an CCRN, and she works with Interventional Radiologists. One of them is in currently in Colorado for 3 weeks skiing with his family. They both get 15 weeks vacation time a year. That's a pretty sweet gig if you ask me.

Not to sound mean, but I really think this is kinda BS. 100,000 is more than adequate for someone who is somewhat good with money to be very comfortable. Especially if that someone comes across a wife that makes a nice living as well, such as $50-60,000.

More importantly is that he is going to be in school for only 5 years, with little or no debt. Becoming a doctor lets say would be APPROXIMATELY 12 years including residency, and would result in 200,000 or so in debt. If he goes the PA way, he has 7 years where he is making a 80-100,000 income. Allowing him to buy real estate, invest in different funds, and even save for a down payment on maybe a second house on the beach that he will rent out.

 

[brucecanbeatyou]

If you aren't sure, I wouldn't commit to a track just because the option is available.

My rule of thumb is: if you're smart enough to get into an accelerated or joint degree program in HS, you are probably smart/dedicated enough to maintain that and get in out of undergrad.

These programs can be good if you absolutely know what you want to do, but if you aren't sure, you're locking into something you might have regrets about later if you change your mind when more information comes to light. There's no reason you HAVE to choose now. The program just happens to be available for those that already made the choice and wouldn't be happy with anything else.

Seconded. You've shadowed MD's and PA's, you have enough information to make a decision... if you were really in love with either one. But the fact that you're asking this question suggests that you're not. I agree with Depakote; don't commit to something you don't need to commit to. If you can get a scholarship in the 5 year program, you can get scholarships for undergrad elsewhere. And besides, maybe during your undergrad you'll change your mind and choose a completely different field. I swore I was going to teach history going into and for the first few years of undergrad, until I discovered medicine and fell in love with it.

Not commiting now is like giving yourself a present which you can afford - time. I at least was grateful for the opportunity to explore the world and get to know myself better in undergrad, before making any final decisions. Most Americans change majors several times in college. Good luck with your decision.

 

[tennisball80]

Hi all,

Thanks for the help I received in a previous thread. I have come back for more advice!

A little about me: I'm a junior who will be applying to colleges this summer and I'm trying to figure out exactly what I want to do. I have the option of a 5 year physician assistant program at University of Detroit Mercy, where I should be able to get a full ride based on my GPA and ACT, or I could go premed at UMichigan or other instate schools.

Originally I thought that I wanted to become a doctor, but soon realized that I would be 30 by the time I was actually out of residency! I know that it is a substantial investment of one's time, but I want to start a family and have a life!

My question is: Should I opt for the 5 year PA program?

I've had the opportunity to shadow a PA and the opportunity to shadow a doctor. I like both relatively equally, though for different reasons. A doctor is the main show and in charge. But a doctor has to fill out a million forms, worry about malpractice, be on call, and work longer hours (of course this varies, but this seems to be the general trend).

A PA on the other hand has the autonomy to diagnose patients, has more time with them, has less stress, doesn't have to worry about malpractice (to an extent), and has slightly less paperwork. But PAs get paid less and some patients are hesitant to be treated by a PA.

I am honestly not too concerned about the reimbursement aspect of the career, as I want to go into primary care and either way there is no money in primary care. I am really just interested in enriching patient's lives and actively counseling them, helping them to make sound medical decisions, and respecting their wishes. I either want to go into peds or geriatrics.

So what do the brilliant minds of SDN think? Should I opt for a life and an early graduation date but a lower salary? Or should I opt for the prestige but all the stress inherent in being a doctor?

Enlighten me!

5 year program saves tons of $$% and tons of time and tons of $()*#()*()&@. I would recommend you going to PA.

You seem to have good reasons

 

[Maygyver]

You seem to have good reasons, however, if you are having to ask the question, you must have some doubt. Go with your heart.

 

[Law2Doc]

If you aren't sure, I wouldn't commit to a track just because the option is available.

My rule of thumb is: if you're smart enough to get into an accelerated or joint degree program in HS, you are probably smart/dedicated enough to maintain that and get in out of undergrad.

These programs can be good if you absolutely know what you want to do, but if you aren't sure, you're locking into something you might have regrets about later if you change your mind when more information comes to light. There's no reason you HAVE to choose now. The program just happens to be available for those that already made the choice and wouldn't be happy with anything else.

Agreed. By virtue of the fact that you are asking the question, it means you need more time to explore more options. The PA option will still be there once you finish college. And many many more doors will be open to you as well. This country doesn't have many direct from high school professional paths precisely for the reason that too many people tend to do better if they have a few more years to figure out what they want to do, and we'd rather have people think things out than have very high attrition like other countries have. Since you are asking the question, you are among these folks who could benefit from a bit more seasoning. Spend 4 years at college. It will probably be the best 4 years of your life. And while you are there, research different paths and figure out which one works for you. While it's understandable that you don't want to "waste your 20s", take it from a career changer that if it ends up that the path you chose out of high school is the wrong one, it will take a while to get up to speed for med school and you will end up "wasting" even more time (not that it's really a waste -- you will get older at the same rate no matter what you do).

 

[Gallix23]

Not to sound mean, but I really think this is kinda BS. 100,000 is more than adequate for someone who is somewhat good with money to be very comfortable. Especially if that someone comes across a wife that makes a nice living as well, such as $50-60,000.

More importantly is that he is going to be in school for only 5 years, with little or no debt. Becoming a doctor lets say would be APPROXIMATELY 12 years including residency, and would result in 200,000 or so in debt. If he goes the PA way, he has 7 years where he is making a 80-100,000 income. Allowing him to buy real estate, invest in different funds, and even save for a down payment on maybe a second house on the beach that he will rent out.

Just saying from experience, my parents make a very similar amount of money to what you just said, and I'm in in NO WAY going to my "house on the beach" this summer. Especially in this economy, we don't really have money to live luxuriously. Like I said, it isn't horrible and we're not like struggling, but it'd be nice to have some extra cash to take that vacation to Florida this summer.

But that's just the way I see things. I think that going to the long route and coming out having an awesome job making a ton of money is way more worth it than just settling for becoming a PA and making an alright salary forever. I also have a mother who is a nurse (and even though she loves her job) tells me every day that I should become a physician and how much she regrets not going all the way. However, I am not the OP, so in the end it's up to him and what he values.

Oh, and you also have to remember that DURING a good chunk of those 12 years, you are making a salary of 40-60 thousand dollars a year, which, according to what you said, is a nice living.

 

[NonTradMed]

Is it possible to do the PA program and then, if you decide to do med school, apply to med school? I mean, you will need a four year degree anyways for med school, would your PA program grant you a BS/BA upon graduation?

If this is an either/or proposition, I suggest you go to college and do your prereqs and explore the options of PA/MD. Continue shadowing, continue volunteering in the medical field.

Also, as another poster mentioned, go to the PA forum and ask what they think about their career. Most PAs on SDN are aiming for medicine or other terminal degree, so the advice they give will be skewed.

One last thing, you have a life while training as a doctor. You're life doesn't start after training. The best part of my life is college, and med school has it's fun aspects too. Also, there are residency programs that are not stressful and work you as much as most jobs, so you don't have to put things on hold with residency either.

Plenty of people in residency start families, buy homes, build careers. Here's the kicker, plenty of college graduates also work 60-80 hours/week, and start families, buy homes and build careers. The 20's are prime career building time for ambitious young professionals. Medicine just as an inflexible, built in system installed that forces you to work crazy hours, but corporate America is just as crazy for those ambitious young'uns who aspire for the brass ring.

 

[Salvorix]

One last thing, you have a life while training as a doctor. You're life doesn't start after training. The best part of my life is college, and med school has it's fun aspects too. Also, there are residency programs that are not stressful and work you as much as most jobs, so you don't have to put things on hold with residency either.

Plenty of people in residency start families, buy homes, build careers. Here's the kicker, plenty of college graduates also work 60-80 hours/week, and start families, buy homes and build careers. The 20's are prime career building time for ambitious young professionals. Medicine just as an inflexible, built in system installed that forces you to work crazy hours, but corporate America is just as crazy for those ambitious young'uns who aspire for the brass ring.

Very true. Pretty much most business and law graduates that are working at prestigious firms (and are the ones building their careers so in 10+ years they will be making comfortable 6+ figure salaries) out of undergrad are going to be working pretty crazy hours. Young people building their careers here in America usually are not just working 9-5, with medicine however working long hours is required, whereas it might not be required in others careers but it is necessary to build one's career/become successful.

 

[deleted6669]

the pathway for the majority of students who decide in high school that they want to work in medicine should be md, not pa.
the exception would be the 18 yr old with prior experience as an emt/cna/medical assistant/etc who has had exposure to medicine, understands all the different roles through direct work experience, and can make an informed choice to take the next step to pa.
pa should not be an entry level health profession as that is not what it is intended to be.

 

[Salvorix]

the pathway for the majority of students who decide in high school that they want to work in medicine should be md, not pa.
the exception would be the 18 yr old with prior experience as an emt/cna/medical assistant/etc who has had exposure to medicine, understands all the different roles through direct work experience, and can make an informed choice to take the next step to pa.
pa should not be an entry level health profession as that is not what it is intended to be.

True. Previous heath care experience is very important in becoming a PA since there is no residency, and thus a lot of knowledge is gained by on the job training. Having minimal/no previous health care experience will probably put you behind the learning curve for a while.

I was considering being a PA as a possibly future career choice (I never intended to apply to any joint programs for any kind of profession) but I've decided now that I am going to consider becoming a physician instead because I am young and have my whole life ahead of me. That being said, I really respect the roles that PA's play in our health care system and am still open to the possibility of becoming one depending on what life throws at me .

 

[Nikki2002]

I wish someone would have grabbed me when I was a senior in high school and just smacked me around a little bit.


Listen--you are only going to live once. Go to a regular 4 year undergrad--pick your favorite one and the one that you would be happiest at. Start with some sort of science degree (bio, chem, etc) and work toward fulfilling your pre-med requirements.

If after those 4 years you decide you want to be a PA, then that's great. You will have made an informed decision and there are plenty of 2 year programs out there that will suit you well. But if you decide you want to apply for med school then you will have already completed the requirements and you can go from there.

But trust me--you are going to have a completely different outlook in a few years--you may end up not going into healthcare at all!! PLEASE DO NOT LET MONEY (I.E. SCHOLARSHIPS) DECIDE YOUR FUTURE! Give yourself as many options as possible and keep an open mind so that you can lead a happy and fulfilled life.