PA vs MD for a family

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.

pre-unsure

Full Member
7+ Year Member
Joined
Jun 21, 2014
Messages
15
Reaction score
2
Hello, I am a young female interested in a career in medicine who is exploring both the physician assistant and physician careers. I am no where near starting a family at this point, but I would like to begin having children around 27-28 years old.

I know that it can sometimes be hard to balance the strenuous hours of medical careers with a family and kids at home. I also know that your speciality has a big impact on how many hours you may work a week.

My question is do PAs work just as hard (in terms of hours/week) as MDs? Autonomy is not a concern for me, but I would hate to look into the PA profession in hopes of having more family time and end up working just as many hours as an MD....in that case I would of just wished I had gone to medical school.

Please let me know if there are any other aspects I am missing in terms of choosing the MD or PA route. I'd love to hear any extra insight/advice.

Thanks

Members don't see this ad.
 
Take it for what it's worth but I've never met a PA who advised people to go MD whereas there are a ton of MDs who'll tell you to go PA...
 
  • Like
Reactions: 2 users
From what I've seen PA is much, much better for work-life balance, offers respectable compensation, and takes significantly less lengthy training & less debt.
 
Members don't see this ad :)
PA school is definitely more relaxed. I know a few people who went that route because of the similar situation as you.
 
You won't have to go through residency where physicians may work up to 70-80 hours a week. You will also be always able to explore and change the area of medicine you are working in. You will not however be ever making more than $100-150,000. PA school is also much less competitive to get into, so that might be a deciding factor plus whether you are comfortable with not being the highest level health care provider (aka physician).

If you haven't started any pre-med courses yet, nursing offers the most flexibility among the three and apparently will eventually become a completely autonomous area of practice.
 
  • Like
Reactions: 1 users
Seems to me that PAs can do many of the same things doctors can do, but will always be required to be - at some level - under the supervision of a physician. If not being in charge would be a constant thorn in your side, go MD/DO. If you can cope with never being the boss, go PA.
 
  • Like
Reactions: 2 users
You won't have to go through residency where physicians may work up to 70-80 hours a week. You will also be always able to explore and change the area of medicine you are working in. You will not however be ever making more than $100-150,000. PA school is also much less competitive to get into, so that might be a deciding factor plus whether you are comfortable with not being the highest level health care provider (aka physician).

If you haven't started any pre-med courses yet, nursing offers the most flexibility among the three and apparently will eventually become a completely autonomous area of practice.

Oh the horror!
 
  • Like
Reactions: 11 users
Take this post with a grain of salt. You are, after all, on SDN.

Don't hang on to the fact that PA schools are "less competitive." The number of applicants are going up exponentially every year. Our school, 4 years ago, only saw 500 students apply for 100 seats. This year, they had ~1,800 apply for 105 spots. I know the example I gave is too small of a sample size, but this is happening all over the country. Also, many schools require tremendous clinical hours that most students become EMTs, Scribes, Medical Assistants, Nurse Assistants, or do clinical research for 1-2 years after (or sometimes during) undergrad. Our sister program requires ~500 hours to be considered. Places like UC Davis requires at least 1,000 hours. Once you're in, you have 2-3 years of non-stop classes throughout the year (no summers off) that are, in essence, like the first two years of medical school. Also, with great power comes great responsibility. A lot of PAs now have to keep up with medical advances by attending conferences, spending time at home studying (not near compared to being a physician), and going to committee meetings for sepsis, ICU, etc. (whatever you get involved in). One hospital I volunteered at forced every medical personnel to work 12-hour shifts at least 5 shifts/week at the NP, PA, and Physician level. Some did 2.5 24-hour shifts and were done, while others worked throughout the week, including weekends. That was a level 3 trauma center. At a level 1 trauma center that I did lab work in had PAs work four 12 hour shifts plus every other weekend (Saturday and Sunday) on-call. They got to be at home, but since it was the only level-1 trauma center for 100 miles in all directions, they had to pretty much stay in the hospital. **Please note that this varies from hospital to hospital. This is NOT true for every level I trauma center in the US**

The Pros? After schooling is done, you have a job. I'm not sure if the school helps you match into one (like medical students) or you have to apply during classes before you graduate. Either way, the market is phenomenal for becoming a PA. They are given a lot of autonomy that frees them from the need of physicians to breathe down his/her neck. Can you open up a clinic of your own? No, not without a physician overseeing your work (the specific "nature" of what you can/can't do escapes me). Now, the surgical PA I shadowed wished that he had became a physician because he worked in a hospital that gave him no respect, but I will tell you now a lot of posters here have nothing but positive things to say about PAs they know. There is no such thing as "you're a physician's assistant, I want a doctor!" anymore. Everyone will see you as a doctor, no matter if you have the "PA" letters stuck next to your name. When you're in the ER and an emergency is in trauma room 1 and you're the only one around, you will be running the shots. When a physician isn't there, you are next in line to conduct the musical per say.

In all, you really just need to shadow several PAs (for a good amount of hours too!) to fully understand what they go through. There is no such thing as a dream job. I am but a simple medical student that has seen a good amount of every side before choosing the physician's path.
 
Last edited:
  • Like
Reactions: 1 users
Oh the horror!
$100,000 doesn't cut it in a lot of places anymore, especially in places like California. The median income for the town I currently live in is slightly over $200,000, kind of insane.
 
  • Like
Reactions: 1 user
You won't have to go through residency where physicians may work up to 70-80 hours a week. You will also be always able to explore and change the area of medicine you are working in. You will not however be ever making more than $100-150,000. PA school is also much less competitive to get into, so that might be a deciding factor plus whether you are comfortable with not being the highest level health care provider (aka physician).

If you haven't started any pre-med courses yet, nursing offers the most flexibility among the three and apparently will eventually become a completely autonomous area of practice.
What do you mean by that?
 
Hello, I am a young female interested in a career in medicine who is exploring both the physician assistant and physician careers. I am no where near starting a family at this point, but I would like to begin having children around 27-28 years old.

I know that it can sometimes be hard to balance the strenuous hours of medical careers with a family and kids at home. I also know that your speciality has a big impact on how many hours you may work a week.

My question is do PAs work just as hard (in terms of hours/week) as MDs? Autonomy is not a concern for me, but I would hate to look into the PA profession in hopes of having more family time and end up working just as many hours as an MD....in that case I would of just wished I had gone to medical school.

Please let me know if there are any other aspects I am missing in terms of choosing the MD or PA route. I'd love to hear any extra insight/advice.

Thanks

You should try taking the MD prereqs at your college right now, while shadowing doctors, and then maybe decide if your mind has changed one way or another.

If I was in your situation, I would incline towards nursing though.
 
What do you mean by that?

Nursing has become an option for some who want to be midlevel clinicians because they also have a program, referred to as the NP degree.

The one caveat is that NP degrees take mostly RNs and BSN holders, so if you don't have one of those degrees, you're at a disadvantage for those programs.

The reason why some hold NP > PA is because in some states, they have the freedom to prescribe medication and the like. They don't need a supervising physician; and there are places like CVS/Walgreens and their in-store clinics that actively take NPs.

An NP program typically takes 2-3 years, although some are trying to become doctorate-oriented like how PT became DPT.

OP, I'm a girl too. Sometimes I do worry about the work-life balance. That's why I'm also looking at fields like dentistry, pharmacy, and vet med. None of those three require a residency to practice; their residencies are typically shorter as well(the obvious exception being OMFS in dentistry).

I'll be honest with you- from what I've heard, it's never convenient timing to have a family. If that's a priority for you, and you want an MD at the end of the day, then maybe you could try to pick a specialty with more reasonable hours. Psych, Peds, FM, and the ROAD specialties come to mind. The first three have 4 year residencies, which would put you at around your target age. ^^
 
  • Like
Reactions: 1 user
Members don't see this ad :)
$100,000 doesn't cut it in a lot of places anymore, especially in places like California. The median income for the town I currently live in is slightly over $200,000, kind of insane.

This is the range of wages as estimated for a PA in the Los Angeles area. I used a Cost of Living calculator and saw that the median of 90k in the Los Angeles area is the same as 65k where I live, by RDU.

65k here isn't bad pickings; you can be pretty self sufficient on that. You can't buy your house in cash or anything, but you're by no means impoverished.

But, if I'm to be honest, the fact that six figures doesn't cut it in CA is more indicative of CA's problems than anything else. You all have some rather nasty inflation over there.
 
  • Like
Reactions: 1 users
I'll be honest with you- from what I've heard, it's never convenient timing to have a family. If that's a priority for you, and you want an MD at the end of the day, then maybe you could try to pick a specialty with more reasonable hours. Psych, Peds, FM, and the ROAD specialties come to mind. The first three have 4 year residencies, which would put you at around your target age. ^^

Two things about your post.

1) NP programs only take BSN or other post-bacc candidates. They do not take someone out of a 2 year RN program.

2) Peds and most FM programs are three years, not four. Unless you do a chief year after, which you don't have to if you're planning on going into private practice.

OP, PAs are like perpetual residents with better hours and better pay. If you don't mind being in the role of a resident with a supervising MD/DO over you all the time, then it's a great field. If you want to climb the responsibility ladder and be the leader of the healthcare team, you're better off going MD and carefully planning your time.
 
  • Like
Reactions: 2 users
Two things about your post.

1) NP programs only take BSN or other post-bacc candidates. They do not take someone out of a 2 year RN program.

2) Peds and most FM programs are three years, not four. Unless you do a chief year after, which you don't have to if you're planning on going into private practice.

OP, PAs are like perpetual residents with better hours and better pay. If you don't mind being in the role of a resident with a supervising MD/DO over you all the time, then it's a great field. If you want to climb the responsibility ladder and be the leader of the healthcare team, you're better off going MD and carefully planning your time.

I know some of them do bridge programs, and I wanted to err on the side of caution for the years on the residencies. But thanks for the corrections! :)
 
Nursing has become an option for some who want to be midlevel clinicians because they also have a program, referred to as the NP degree.

The one caveat is that NP degrees take mostly RNs and BSN holders, so if you don't have one of those degrees, you're at a disadvantage for those programs.

The reason why some hold NP > PA is because in some states, they have the freedom to prescribe medication and the like. They don't need a supervising physician; and there are places like CVS/Walgreens and their in-store clinics that actively take NPs.

An NP program typically takes 2-3 years, although some are trying to become doctorate-oriented like how PT became DPT.

OP, I'm a girl too. Sometimes I do worry about the work-life balance. That's why I'm also looking at fields like dentistry, pharmacy, and vet med. None of those three require a residency to practice; their residencies are typically shorter as well(the obvious exception being OMFS in dentistry).

I'll be honest with you- from what I've heard, it's never convenient timing to have a family. If that's a priority for you, and you want an MD at the end of the day, then maybe you could try to pick a specialty with more reasonable hours. Psych, Peds, FM, and the ROAD specialties come to mind. The first three have 4 year residencies, which would put you at around your target age. ^^

Not to mention that NP's are under the board of nursing, as opposed to the board of medicine ;)

They can also do the non-clinical component of their education online.

Here's a quote that may help:

To be fair, the only reason PAs can't encroach further in Derm, is bc they fall under the Board of Medicine. Unlike nurses, who fall under the Board of Nursing.

Hence why all they need is:
  • Current NP State Licensure
  • Master's degree in nursing
  • National certification as a nurse practitioner
  • 3,000 hours of general dermatology practice with a current practice in dermatology
and you too can call yourself a "board-certified dermatologist".

http://www.dnanurse.org/sites/default/files/downloads/2014/DCNP_Brochure-App_Combined_0.pdf

DNCB%20pie%20image.jpg

That was from this thread: http://forums.studentdoctor.net/threads/dermatology-pas.1062886/

You may want to read it to obtain a non-premedical perspective on PA/NP. You should also take note of the direction recently passed legislation is moving. It seems as though you would get more income potential as a NP, while having the ability to maintain an easy lifestyle
 
Last edited:
  • Like
Reactions: 1 user
Yeah, $150,000 a year is not nearly enough.....especially if your husband is working.

Verging on sexism there @Gregor Wiesmann. Financial independence and security is important for every adult, especially one who wants to have children. Depending on your husband financially is not a safe or wise life plan.
 
  • Like
Reactions: 4 users
Verging on sexism there @Gregor Wiesmann. Financial independence and security is important for every adult, especially one who wants to have children. Depending on your husband financially is not a safe or wise life plan.
And yet there are women who can do that. Men don't have such a fallback.
 
  • Like
Reactions: 1 users
And yet there are women who can do that. Men don't have such a fallback.

And now we've crossed the sexism line.

There are men who are financially dependent on their wives (and on their husbands). I personally know several. For one, it works very well and has for over a decade. For another, it only worked because he secured a "pre-preg" before their child was born, and child support kept him afloat post-divorce until he could reboot his career. A third is somewhat 'trapped' in a marriage that appears to be less than fulfilling. (Yes, I know more women in this position than men.)

But I wouldn't recommend this as a 'life strategy' to anyone. And any young person, male or female, 'hot' or not -- who decides that 'Plan A' should be becoming someone else's financial dependent is making a very foolish choice. What good 'Plan B' options exist if 'Plan A' fails?
 
  • Like
Reactions: 8 users
Verging on sexism there @Gregor Wiesmann. Financial independence and security is important for every adult, especially one who wants to have children. Depending on your husband financially is not a safe or wise life plan.

I thought he was just being sarcastic on the belief that 150,000+husband pay is not enough to have a good quality of living.
 
  • Like
Reactions: 1 user
And now we've crossed the sexism line.

There are men who are financially dependent on their wives (and on their husbands). I personally know several. For one, it works very well and has for over a decade. For another, it only worked because he secured a "pre-preg" before their child was born, and child support kept him afloat post-divorce until he could reboot his career. A third is somewhat 'trapped' in a marriage that appears to be less than fulfilling. (Yes, I know more women in this position than men.)

But I wouldn't recommend this as a 'life strategy' to anyone. And any young person, male or female, 'hot' or not -- who decides that 'Plan A' should be becoming someone else's financial dependent is making a very foolish choice. What good 'Plan B' options exist if 'Plan A' fails?

I'm financially dependent on my wife. I go to school and make $12k a year working weekends. If she didn't have an MBA I'd be eating beanie weenies sleeping at the bus stop.
 
  • Like
Reactions: 4 users
There is no such thing as "you're a physician's assistant, I want a doctor!" anymore. Everyone will see you as a doctor, no matter if you have the "PA" letters stuck next to your name. When you're in the ER and an emergency is in trauma room 1 and you're the only one around, you will be running the shots. When a physician isn't there, you are next in line to conduct the musical per say.

That may have been your experience, but in my experience that is grossly over stating the case. Most patients in our office will refuse to see the PA instead of the physicians; they want the doctor. They will agree to see the PA only if the physicians are unavailable. When given the choice - earlier appointment with the PA or farther out with the physician, they will 9.9 times out of 10, choose the physician. However, we have a highly educated population and I suspect that patients that know the difference want the physician. The rest are those who think NP/PA/MD is all the same.

In terms of hours, there are all sorts of environments and practice types. Our PA makes nearly $100,000 per year, does not take call, does not round on inpatients and generally works under 50 hrs per week. I think that's a pretty good gig. But there are others who do take call, work long shifts, pre-round, weekend rounds, etc.

OTOH, the OP shouldn't buy the Kool Aid that you can't be a female physician and have a family. You may need a supportive partner especially if you're in a high hours field like surgery but its been done many times before.

As others have noted, the OP needs to decide about what element of medical practice appeals to her most and not eliminate one or the other simply because of family concerns.
 
  • Like
Reactions: 2 users
I'm financially dependent on my wife. I go to school and make $12k a year working weekends. If she didn't have an MBA I'd be eating beanie weenies sleeping at the bus stop.
You're not the only one either.

I see many men married to professional women who either couldn't live the lifestyle that her career afford them (i.e., the low level IT guys married to surgeons) or whom couldn't sustain any lifestyle short of living under a bridge (i.e., students, unsuccessful actors/waiters, artists etc). One of my friends is married to a ski instructor who only works a few months out of the year and goes to school during the spring/fall quarters.
 
Hello, I am a young female interested in a career in medicine who is exploring both the physician assistant and physician careers. I am no where near starting a family at this point, but I would like to begin having children around 27-28 years old.

I know that it can sometimes be hard to balance the strenuous hours of medical careers with a family and kids at home. I also know that your speciality has a big impact on how many hours you may work a week.

My question is do PAs work just as hard (in terms of hours/week) as MDs? Autonomy is not a concern for me, but I would hate to look into the PA profession in hopes of having more family time and end up working just as many hours as an MD....in that case I would of just wished I had gone to medical school.

Please let me know if there are any other aspects I am missing in terms of choosing the MD or PA route. I'd love to hear any extra insight/advice.

Thanks
There are physicians who works 40 hrs/week... I know a couple of them (IM/FM), but they probably don't make what the average IM/FM make... The FM guy told me he makes a little over 14ok/year M-F 8-5 with holidays off...

Also, for PA you have to take the certification exam every 6-7 years in order to continue practicing..
 
Last edited:
There are physicians who works 40 hrs/week... I know a couple of them (IM/FM), but they probably don't make what the average IM/FM make... The FM guy told me he makes a little over 14ok/year M-F 8-5 with holidays off...

Also, for PA you have to take the certification exam every 6-7 years in order to continue practicing..
I thought physicians also have to be periodically re-certified.
 
I thought physicians also have to be periodically re-certified.
Board certification..yes...not step 3 to be licensed again... For PA it is for your license so you can continue to practice.
 
So it's a more rigorous test for PA's?
I don't if it is more rigorous for PA... Let say as a physician, you have to take step3 every 7 years in order to renew your license, I don't think that would be fun. This is the case for PA, they have to take the license certification exam every 7 years so they can have a PA license... If they don't pass, they can't practice anymore... As a physician, you have your license for life even if you might not have a board certification... The two physicians I talk about in post # 26 are not board certified but they are working nonetheless...
 
^^ Wrong. Physicians have required Continuing Medical Education seminars/programs etc.-- attendance is mandatory to keep one's medical license (which is renewed every two or three years in most states). Board specialty certification is a separate issue to that of medical license maintenance...
 
  • Like
Reactions: 3 users
seriously go PA . they have increasing autonomy these days and theres a very good job market with very good pay. They have more opportunities to have a better job w/ more flexibility in terms of work hours and location compared to MDs. Their per hour salary is comparable to many MD salaries (xcept for high paying specialities). When i was on surgery, we had two PAs. One chose to work 40 hours a week and earned 170k. The other chose to work 2 full shifts (80 hrs) b/c he's still young and wants to save a lot of money early on. He made ~320k. [this was in nyc]
 
Verging on sexism there @Gregor Wiesmann. Financial independence and security is important for every adult, especially one who wants to have children. Depending on your husband financially is not a safe or wise life plan.
I don't think you got the sarcasm in my post.........
 
I thought he was just being sarcastic on the belief that 150,000+husband pay is not enough to have a good quality of living.
I was, @DokterMom didn't detect the sarcasm and started something that never needed to happen......I personally thought my comment was hilarious.
 
seriously go PA . they have increasing autonomy these days and theres a very good job market with very good pay. They have more opportunities to have a better job w/ more flexibility in terms of work hours and location compared to MDs. Their per hour salary is comparable to many MD salaries (xcept for high paying specialities). When i was on surgery, we had two PAs. One chose to work 40 hours a week and earned 170k. The other chose to work 2 full shifts (80 hrs) b/c he's still young and wants to save a lot of money early on. He made ~320k. [this was in nyc]
I'm no expert, but I don't think students should go the PA route and expect to make that much.
 
Edit:
Others answered it way better.
 
Last edited:
That may have been your experience, but in my experience that is grossly over stating the case. Most patients in our office will refuse to see the PA instead of the physicians; they want the doctor. They will agree to see the PA only if the physicians are unavailable. When given the choice - earlier appointment with the PA or farther out with the physician, they will 9.9 times out of 10, choose the physician. However, we have a highly educated population and I suspect that patients that know the difference want the physician. The rest are those who think NP/PA/MD is all the same.

In terms of hours, there are all sorts of environments and practice types. Our PA makes nearly $100,000 per year, does not take call, does not round on inpatients and generally works under 50 hrs per week. I think that's a pretty good gig. But there are others who do take call, work long shifts, pre-round, weekend rounds, etc.

OTOH, the OP shouldn't buy the Kool Aid that you can't be a female physician and have a family. You may need a supportive partner especially if you're in a high hours field like surgery but its been done many times before.

As others have noted, the OP needs to decide about what element of medical practice appeals to her most and not eliminate one or the other simply because of family concerns.

In the practice where I do research, the PA often takes the role the resident does and there are two here:

They do pre-ops, often round on patients, and often see patients by themselves. I think it's rare for patients to complain about 'no doctor' here, but the way clinic usually works is that the PA gets the patient history and notable complaints then relays this to the attending. Attending goes in and sees patient with PA for a short time and agrees with the plan. PA dictates notes and attending signs off on the note saying they were present for the consultation.

This allows the attending to see far more patients that day (as there's usually a PA and resident/med student at the hospital). There are times when the attendings have cases and will consult on patients between cases and during cases if there's a fellow or resident operating with them. Here, the PA will see the patient and the surgeon will pop in and out before scrubbing back into the case.

Regarding time: I think the PA's have far less responsibilities once they leave the clinic. This is why they decided to go the PA route. One of them scrubs in to cases, but the other doesn't do that anymore. One also works 4x10hr days and has 3 day weekends every weekend.
 
Last edited:
Are you saying I'm sexist for assuming that the man in the relationship might also be bringing in money?

What I said was that your original comment VERGED on sexism - so came close. Implying that a woman's income is of lesser importance because of her presumed husband's presumed income -- yeah, that's kind of sexist. Would you have said the same thing had you known the OP was a guy? That his income wasn't important because of his wife's income? Don't think so...

Yeah, $150,000 a year is not nearly enough.....especially if your husband is working.
 
  • Like
Reactions: 1 user
In the practice where I do research, the PA often takes the role the resident does and there are two here:

They do pre-ops, often round on patients, and often see patients by themselves. I think it's rare for patients to complain about 'no doctor' here...

Our patient population is notorious for being high maintenance and expecting to see the physician. That is very different than many other specialties where the PA may be more accepted .
 
Last edited:
  • Like
Reactions: 1 user
What I said was that your original comment VERGED on sexism - so came close. Implying that a woman's income is of lesser importance because of her presumed husband's presumed income -- yeah, that's kind of sexist. Would you have said the same thing had you known the OP was a guy? That his income wasn't important because of his wife's income? Don't think so...
LOL, way to make something out of nothing. I never said anything about the husband making MORE, or that somehow a women's income is insignificant. That's purely your twisted interpretation of my statement. I was simply implying that $150,000 is a lot of money for a single earner, and if she had a husband who was working too, then they would be doing pretty darn well. You can't accuse me of coming close to sexism because I never said anything of the sort. Oh, and to answer your question, yes, I would have said the same thing if it was a guy, because a lot of families now days are dual-income.
 
  • Like
Reactions: 1 user
seriously go PA . they have increasing autonomy these days and theres a very good job market with very good pay. They have more opportunities to have a better job w/ more flexibility in terms of work hours and location compared to MDs. Their per hour salary is comparable to many MD salaries (xcept for high paying specialities). When i was on surgery, we had two PAs. One chose to work 40 hours a week and earned 170k. The other chose to work 2 full shifts (80 hrs) b/c he's still young and wants to save a lot of money early on. He made ~320k. [this was in nyc]

Can I ask how you know how much these people make with such certainty? I'm genuinely curious because I have close physician friends and I feel it's too awkward to even ask them how much they make. Also, those numbers seem abnormally high. Not saying it's not true, but it just seems shocking to me, especially when we hear physicians making next to nothing in the more desirable areas.
 
Medican salary was $95,000 this past year I believe.
 
Can I ask how you know how much these people make with such certainty? I'm genuinely curious because I have close physician friends and I feel it's too awkward to even ask them how much they make. Also, those numbers seem abnormally high. Not saying it's not true, but it just seems shocking to me, especially when we hear physicians making next to nothing in the more desirable areas.

because someone working with them told me, and also because i confirmed it by looking it up online. im in a public institution so employee salary is public
 
because someone working with them told me, and also because i confirmed it by looking it up online. im in a public institution so employee salary is public
But you would agree that those salaries you listed were abnormally high, right?
 
But you would agree that those salaries you listed were abnormally high, right?

Probably, but ive only worked w/ 3 PAs, 2 listed above, and 1 other says she makes more than pediatricians. Two are in their 20s. But since the average PA salary seems to be lower than what I listed, perhaps I'm in a high paying area or they just make a lot for PAs for some reason. Perhaps the hospital I'm at pays a lot [im in nyc]
 
Top