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PA vs MD

ailuj9

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    So I was wondering if I could get a little advice on a few questions. I have wanted to be a doctor forever. I had an ok undergrad GPA and 2 terrible MCAT scores. My health advisor told me about PA school. I researched it and it sounded a lot like what a doctor does with more flexibility. I want to work with patients and be independent, much like a doctor, but I also do not mind working on a team. I was wondering if you had any advice. If any of you were in this situation and what you did about it.

    Other questions I have are:
    Is it advantagous to have a PA/MPH degree over a PA degree if I am only going to practice? If I didn't want to just practice, what exactally would I do with the MPH degree?

    Thanks for the advice!
     

    ailuj9

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      Pose said:
      Just to clear something up. The only reason you want to go to PA school is because of your low MCAT scores?


      No. Like I said: "I want to work with patients and be independent, much like a doctor, but I also do not mind working on a team."

      Basically I did not know about the PA profession until about a year ago. I knew I wanted to work in health care and I thought I could only be a doctor. My advisor told me I should apply to med school, but my chances of getting in were low due to my grades/MCAT scores. The advisor also told me to look into PA school...So here I am.
       
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      Emedpa

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        the avg md applicant does not qualify for pa school admission.there is this little requirement called "prior healthcare experience", something most premeds don't have. take a kaplan course, retake the mcat and go to medschool. also look into carib med schools -they are less picky about mcats.
         

        Febrifuge

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          In my experience, the PA schools also want a more varied block of pre-reqs already done before they'll let you in. I'm doing a one-year postbac to fill all my med school pre-reqs, but if I wanted PA school I'd have to do those same classes (well, minus the Physics), and also some A&P, Genetics, Cell Bio, and maybe more, depending on the school.

          Overall, this perception -- that PA school is a good choice for when med school doesn't seem to be working out -- is way off-base. PA is an awesome career path, but it should only be undertaken by people who want to be kick-ass PAs.
           

          stevo23

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            I just wanted to add a few things to the original post as I am in somewhat of a similar situation. I have been out of undergrad for a year now and always wanted to go to med school. However, due to unfortunate health issues, bad MCATS, and mediocre grades, med school realistically couldnt happen for a few years. It's hard to stay motivated when it will be at least 2 more years until I enter school. Currently, I consent patients for studies, take blood, volunteer at Shock Trauma (UMD), and have racked every physician's brain that I work with about the rigors of medical school (I work at Hopkins). Having said this, I know that I love being with patients and have a genuine passion for medicine, but having a family and BEING AROUND for that family is extremely important to me. Do you think I am off-base to pursue PA given what I have said? I understand a PA's role and feel it could be a perfect fit for me, and yes I did want to attend medical school in the past. With all due respect, I think there are many that have gone before me in this similar situation. Until you fully understand what a PA is capable of, you can't appreciate their contributions to the healthcare team. You assume being a doctor is the only way. With all the similarities between the two professions, how could there not be many aspiring med students who realize that they would be very happy being a PA? I'd be willing to bet that better than half of PA's thought about med school and maybe even took their MCAT's and applied. Every practicing PA and current PA student I know gravitated from med school to PA. I just wanted to share my thoughts and certainly respect everyone else's thoughts on the matter as well. Any feedback would be helpful. Thanks.

            Steve
             

            ailuj9

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              stevo23 said:
              I just wanted to add a few things to the original post as I am in somewhat of a similar situation. I have been out of undergrad for a year now and always wanted to go to med school. However, due to unfortunate health issues, bad MCATS, and mediocre grades, med school realistically couldnt happen for a few years. It's hard to stay motivated when it will be at least 2 more years until I enter school. Currently, I consent patients for studies, take blood, volunteer at Shock Trauma (UMD), and have racked every physician's brain that I work with about the rigors of medical school (I work at Hopkins). Having said this, I know that I love being with patients and have a genuine passion for medicine, but having a family and BEING AROUND for that family is extremely important to me. Do you think I am off-base to pursue PA given what I have said? I understand a PA's role and feel it could be a perfect fit for me, and yes I did want to attend medical school in the past. With all due respect, I think there are many that have gone before me in this similar situation. Until you fully understand what a PA is capable of, you can't appreciate their contributions to the healthcare team. You assume being a doctor is the only way. With all the similarities between the two professions, how could there not be many aspiring med students who realize that they would be very happy being a PA? I'd be willing to bet that better than half of PA's thought about med school and maybe even took their MCAT's and applied. Every practicing PA and current PA student I know gravitated from med school to PA. I just wanted to share my thoughts and certainly respect everyone else's thoughts on the matter as well. Any feedback would be helpful. Thanks.

              Steve


              Steve, I am with you all the way. I was asking advice on PA school because I do want to have a family and I realize that if I try for med school it could be 3 or 4 years before I even get in and then 8+ years before I am actually done (I am also out of undergrad for 2 years now and motivation is extremely difficult). I see PA's as very similar to doctors, in fact most of the PA's I worked with I thought were MD's and then I realized they had taken a different path to do exactally what I want to do, which is work with patients in health care. You should try and shadow a PA or meet with them. From what I have seen/experienced, they perform very similar tasks to MD's and are extremely happy with their careers. Has anyone else also seen/experienced this?

              In response to the other posts, I am not trying to say that one career choice is better than the other. I am just wondering about differneces/similarities. I am trying to make an informed decision before spending thousands of dollars on education, whatever path that may be.

              Thanks for your responses!
              Julia
               

              lawguil

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                ailuj9 said:
                Steve, I am with you all the way. I was asking advice on PA school because I do want to have a family and I realize that if I try for med school it could be 3 or 4 years before I even get in and then 8+ years before I am actually done (I am also out of undergrad for 2 years now and motivation is extremely difficult). I see PA's as very similar to doctors, in fact most of the PA's I worked with I thought were MD's and then I realized they had taken a different path to do exactly what I want to do, which is work with patients in health care. You should try and shadow a PA or meet with them. From what I have seen/experienced, they perform very similar tasks to MD's and are extremely happy with their careers. Has anyone else also seen/experienced this?

                In response to the other posts, I am not trying to say that one career choice is better than the other. I am just wondering about differences/similarities. I am trying to make an informed decision before spending thousands of dollars on education, whatever path that may be.

                Thanks for your responses!
                Julia

                Julia,

                I am not a PA or MD/DO, but I advise people who are considering these lifestyles. Their are some differences, but they are definitely more similar than different. Basically, MD/DO's have a few more privileges with admitting patients ect. It really varies state to state so you should review the practice requirement for the states that you are interested in practicing. If you were to shadow a PA and an MD without knowing what you were shadowing, you probably wouldn't know the difference unless you were observing a surgeon. I think you’re in an excellent position for PA school. It is true that some school require past/previous medical experience, however, some schools overlook experience. Further, obtaining an EMT license and volunteering might be the ticket you need. I wouldn't give up simply because I know that PA school is very do-able for a pre-med student! Just my experience. L.
                 

                iliketocut

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                  I wanted to post on this thread to correct some misperceptions. It is uneducated and incorrect to even compare a PA to an MD. Becoming a physician requires a tremendous amount of sacrifice (time-wise, financial, emotional, etc.) It is a long, but rewarding road and at the end of it, you know that you are the ultimate leader of the healthcare team. Your patients put their lives and trust in your hands and look to you to make them better.

                  PA's, while intelligent and valuable, are considered "ancillary staff" just as nurses and NP's are. They are, as their title suggests, "physician ASSISTANTS" and they assist the medical team in caring for the patient. They are not, however, the ultimate decision makers and they do not have the opportunities that physicians do.

                  While PA's are very valued, I think that if you asked any of us (MD's) we would not trade places with them for anything. You must decide what the right path is for you and pursue it. But please do not have any illusions about what your role will be and please don't think that you will be in any way eqivalent to a physician. It is like comparing apples and oranges.
                   

                  Febrifuge

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                    I hear what you guys are saying and it sounds like PA is the right way to go for you; plenty of people catch on to the PA thing later, after pursuing the MD-or-DO route for a while. A lot of times, advice is geared toward doctoring and it's like nothing else exists as an option. There's absolutely nothing wrong with realizing during your search that what you really want is to be a PA.

                    I'm just saying there's a difference between that and a person (not necessarily you guys) saying "gee, I was planning on being a doctor, but then bad grades and MCATs drove me to the PA route." There's a connotation to that, and I'm sure you wouldn't want to be associated with it.

                    I know and work with some awesome PAs. Most of them could have easily done med school, but had reasons for choosing PA. Family is a big one. Choosing the more collaborative working style is another. Some people are better-suited to one route or another, and what they see as positives others might see as negatives. Choose based on the work you'll be doing the rest of your career, not just the degree to which you're able to attain admission to school or whatever in this particular time and place.

                    That's all I'm saying. Choose PA because PA is what you want, not because your original plan isn't working out and suddenly this seems like a great Plan B. Think about not just where you can get to right now, but where either path would take you in 5 years, in 10 years, in 15 years.
                     

                    iliketocut

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                      "...saying "gee, I was planning on being a doctor, but then bad grades and MCATs drove me to the PA route." There's a connotation to that, and I'm sure you wouldn't want to be associated with it."

                      You have to understand that for many people who do not have the credentials to get into medical school, PA school is often presented to them (by advisors) as a viable option (along with nursing, DO school or foreign med schools). I know because this happened to me. I went to a strong liberal arts school that was a pre-med factory. If you didn't have a 3.6 GPA and a 34 MCAT, you were told to start considering other options. Although harsh, it is reality. I personally chose not to compromise my goals, took some time to clean up my application and was accepted to a top medical school. It's not politically correct to say that med students are "smarter" than everyone else and it's not true. But they do have something within them that pushed them to achieve a loftier goal (by that I mean more schooling, more training and a more rigorous schedule). And take it from someone who knows, you can have a family, a life, a marriage, etc. as a physician. Don't use those things as an excuse not to go to med school. One of my classmates was a 38 year old former nurse with four kids. It is hard, but not impossible.
                       

                      hospPA

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                        ailuj9 said:
                        So I was wondering if I could get a little advice on a few questions. I have wanted to be a doctor forever. I had an ok undergrad GPA and 2 terrible MCAT scores.

                        If you mean less than 3.2 or so when you say "OK" undergrad GPA, that won't cut it in most programs. You also need medical experience to get into most programs. PA school should not be a second choice for those who cannot get into medical school.

                        For the record, PA's in my area are not considered ancillary staff. We are considered part of the medical team, partners with the doctors. You could lay off the caps and make your misguided point. Assistant is not an appropriate name for what we do, but we can't seem to get that changed. Seeing 20 patients a day in a clinic with a physician down the hall is not "assisting". I would argue that holding retractors and cutting suture is assisting. I guess it depends on what field the PA is in.

                        Good luck in whatever you decide,

                        Pat
                         

                        iliketocut

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                          How can you even consider yourself an equal partner with people who have more education and training than you? Don't be foolish. Physicians are "partners" with their peers, whether in a private practice or hospital setting. I wouldn't open a private practice with a "PA" I would do so with other physicians.

                          Please at least acknowledge that you cannot be equal partners with people who exceed you in education and training. One problem I have noticed with PA's is that they have an inferiority complex and tend to try and "compete" with physicians, which is ridiculous. I also highly doubt that if the physicians at your institution were surveyed, they would consider themselves partners with the PA's.
                           
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                          lawguil

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                            iliketocut said:
                            How can you even consider yourself an equal partner with people who have more education and training than you? Don't be foolish. Physicians are "partners" with their peers, whether in a private practice or hospital setting. I wouldn't open a private practice with a "PA" I would do so with other physicians.

                            Please at least acknowledge that you cannot be equal partners with people who exceed you in education and training. One problem I have noticed with PA's is that they have an inferiority complex and tend to try and "compete" with physicians, which is ridiculous. I also highly doubt that if the physicians at your institution were surveyed, they would consider themselves partners with the PA's.

                            Please, not another 'I'm better than you' debate. Everybody knows that physicians MD/DO have more training than a PA ect. We all understand the hierarchy of the medical team and it will always be a system with physicians at the top in healthcare. Why challenge it and more importantly, why put any effort forth saying physicians are at the top. I’m sure as a physician you don’t have to explain yourself very often.
                             

                            Jengirl18

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                              iliketocut,

                              I'm sorry you've had/seen PAs act in a manner that you or other physicians find offensive. If the PAs are not sticking to their scope of practice, that's one thing...but remember that PAs are educated by physicians, and that the "supervising physician" determines how big the scope (as long as the laws allow it.) Would u mind telling a brief example of what you have seen in the past as to PAs competing with the docs? Thanks.
                               

                              iliketocut

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                                There is a post in the surgery forum that covers this in detail. We mostly see it at the resident level, when PA's try to go into the OR before residents despite the fact that they were specifically hired for the purpose of seeing to discharges and patient care while residents are operating. Eventually, the attending has to re-clarify the role of the PA and it's embarassing to everyone involved. Attendings absolutely HATE getting involved in this and it puts them in a bad position, but unfortunately it becomes necessary when a PA oversteps their bounds.

                                I have to clarify that a good PA is INVALUABLE and I am in no way putting the profession down. I just think (especially for those making a decision about a career path) that we have to be honest about what each person's role is on the healthcare team. Misleading people is unfair.
                                 

                                ailuj9

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                                  I have to clarify that a good PA is INVALUABLE and I am in no way putting the profession down. I just think (especially for those making a decision about a career path) that we have to be honest about what each person's role is on the healthcare team. Misleading people is unfair.[/QUOTE]

                                  Thank you all for you responses. I would like to continue to recieve more responses to the MD/PA quesiton I originally posted. Does anyone have advice on my second qeustion?

                                  "Is it advantagous to have a PA/MPH degree over a PA degree if I am only going to practice? If I didn't want to just practice, what exactally would I do with the MPH degree? "

                                  Thanks!
                                  Julia
                                   

                                  hospPA

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                                    iliketocut said:
                                    How can you even consider yourself an equal partner with people who have more education and training than you? Don't be foolish. Physicians are "partners" with their peers, whether in a private practice or hospital setting. I wouldn't open a private practice with a "PA" I would do so with other physicians.

                                    Please at least acknowledge that you cannot be equal partners with people who exceed you in education and training. One problem I have noticed with PA's is that they have an inferiority complex and tend to try and "compete" with physicians, which is ridiculous. I also highly doubt that if the physicians at your institution were surveyed, they would consider themselves partners with the PA's.

                                    The word equal was not used in my post, check it out. I said partners, no equal. If you surveyed the docs at my institution, most of them would be comfortable with the use of that terminology. PA's do not compete with physicians, we work with them. I have no inferiority complex. Do you have a God complex?

                                    Pat
                                     

                                    Emedpa

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                                      while my skills are not equivalent to those of en em md, I am considered a partner/colleague in our group. I work for an independent er group of md's, do's, and pa's. we are all partners in the group, all vote, all get profit sharing and production bonuses, and often cross cover each other. the docs sign pts out to me at the end of their shifts and I sign out to them at the end of mine. if a doc is not available to cover an er md shift then a pa fills it. so yes, while not an equal clinically I am both a partner and a professional colleague in the group.
                                      on another note, folks who couldn't cut it in premed would likely not get into pa sachool for the same reasons. most pa programs have >50 applicants for each slot in class with avg class size around 30-40 so a gpa < 3.2 may sink you early on in the application process.
                                      on the question of an mph: if you can get a pa/mph in the same time and for the same price as a pa/mpa doesn't it make sense to get the extra credential? if it had been available when I was in school I would have done it.
                                       

                                      EMDream

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                                        emedpa said:
                                        on another note, folks who couldn't cut it in premed would likely not get into pa sachool for the same reasons. most pa programs have >50 applicants for each slot in class with avg class size around 30-40 so a gpa < 3.2 may sink you early on in the application process.

                                        This I agree with, all schools have a GPA cut off of at least 3.0 (and you'd have to be pretty exceptional to get in with that), and I know most PA's disagree with this but as I've seen at least in my school and other ocal schools it is moving more towards grades then it is experience. They are turning away people with low 3 GPA's with 20 years of experience for 22 year olds with 3.7's. Trust me, I see it in my program, I was shocked that I got in, but it had to be my GPA. I got accepeted with a 3.67 with no real experience over those with years of experience with 3.2's. It's probably not a good thing because in general the PA profession is a great place for other healthcare providers to move up to, and they're much more efficient right out of school I'm sure. I'll require years of training. But that's the way it's going.
                                         

                                        adamdowannabe

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                                          psychologists have said the most messed up childred they encounter are usually children of surgeons. The ego is so large, surgeons seem to place themselves at a different level then the rest of mankind.

                                          Granted, you spent a lot of years training for your career, but surgeons who realize they are still just people, with a really neat job, make for a better doctor then surgeons who think they are godlike..... Spare me, please!

                                          iliketocut you seem to fit the mold, but I challenge you to tell me of an example of one "great thing" you have done, that hasn't been done 10,000 times a year by 10,000 other surgeons around the world? The "I'm better then you attitude" because of the education you have gotten doesn't get very far, in a world where the richest man in the US is a college dropout, and the godfather of modern physics never graduated from highschool, are you better then they are too? Heck, the guy who invented bleach has saved more lives then every doctor who ever had a patient who was going to die if not treated.

                                          What do you really have to offer, as a person, besides the attitude that 5 extra years of school makes you "better" then everyone else?

                                          You claim a PA is foolish to think they are partners with a doctor, I feel it is you, who assumes that education is the only way to gain knowledge, is the foolish one.

                                          Medicine isn't for the money or the prestige anymore "pal" it's for the passion, your anger is misplaced.

                                          I suggest you watch the film "something the lord made"
                                           

                                          adamdowannabe

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                                            iliketocut said:
                                            While PA's are very valued, I think that if you asked any of us (MD's) we would not trade places with them for anything. You must decide what the right path is for you and pursue it. But please do not have any illusions about what your role will be and please don't think that you will be in any way eqivalent to a physician. It is like comparing apples and oranges.


                                            You making a blanketed comment that MD's would not want to trade places with a PA can't be more wrong, I have met a LOT of physicians, who have been practicing medicine for 25-30 years, who have told me if they even knew about the career of physician assistant, or if it was available such as medical school was available, they would have become a PA instead of becoming a physician.

                                            I am wondering if you are still young, a resident? Still new to your career, and not having been faced with a lot of what being a doctor involves? (just a guess.......on my part)
                                             

                                            Docgeorge

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                                              Medicine isn't for the money or the prestige anymore "pal" it's for the passion, your anger is misplaced.

                                              I suggest you watch the film "something the lord made"

                                              If its about the passion for you, do it the right way. Learn all about medicine, the subtlities of the disease and the patient. Learn how seemingly inocuse things are interlinked and lean how to manipulate physiology and anatomy to truly give the best care your patient deserves.

                                              As far as something the lord made, it's a great fictionalized account. What Vivan Thomas contributed to developing Blalock-Taussig (well in all rights it should be Blalock-Taussig-Thomas) shunt and surgical education at JH was nothing short of monumental. Being a medical historian I have issiues with the movie, it glosses over a lot pertinat stuff and totally down plays Helen Taussigs role in comming up with the shunt. A much better film is Partners of the heart.

                                              On another topic I found this link http://www.facs.org/education/gs2004/gs43rosendale.pdf and I thought it might give us something to talk about.
                                               
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                                              iliketocut

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                                                adamdowannabe said:
                                                psychologists have said the most messed up childred they encounter are usually children of surgeons. The ego is so large, surgeons seem to place themselves at a different level then the rest of mankind.

                                                Granted, you spent a lot of years training for your career, but surgeons who realize they are still just people, with a really neat job, make for a better doctor then surgeons who think they are godlike..... Spare me, please!

                                                iliketocut you seem to fit the mold, but I challenge you to tell me of an example of one "great thing" you have done, that hasn't been done 10,000 times a year by 10,000 other surgeons around the world? The "I'm better then you attitude" because of the education you have gotten doesn't get very far, in a world where the richest man in the US is a college dropout, and the godfather of modern physics never graduated from highschool, are you better then they are too? Heck, the guy who invented bleach has saved more lives then every doctor who ever had a patient who was going to die if not treated.

                                                What do you really have to offer, as a person, besides the attitude that 5 extra years of school makes you "better" then everyone else?

                                                You claim a PA is foolish to think they are partners with a doctor, I feel it is you, who assumes that education is the only way to gain knowledge, is the foolish one.

                                                Medicine isn't for the money or the prestige anymore "pal" it's for the passion, your anger is misplaced.

                                                I suggest you watch the film "something the lord made"

                                                I'm sorry adam whatever your name is that you are so angry and hostile. This is often the case with people who are unhappy with themselves. I posted on this thread to correct what I felt were some incorrect statements, not to be attacked. When you grow up a little and mature, maybe you should come back and post again.

                                                I think the children of surgeons would have a lot to say about your stupid comment, a great parent is a great parent regardless of their profession. Talk to me again after you've done your first successful Whipple or hugged a patient during an office visit that YOU did a total gastrectomy on 10 years prior for gastric cancer. Call me when you've spent 7 years as a surgical resident (that includes 2 lab years) and done two years of fellowship and are paying back the $150K you invested in your education.

                                                Good luck with your sad little life...I'm done with this thread.
                                                 

                                                adamdowannabe

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                                                  ** My posts should be mentally read in a calm, soothing, insightful manner, they aren't angry.... and yes, I obviously have a sad little life**


                                                  I would like to revise my statement a touch,

                                                  Yes, the nature of passion might involve the everlasting education model, the "eternal student" which should be the case of every doctor or Pa, I met some "old school" ortho's who weren't up to par with medicine in my opinion, they had this attitude that the way they learned to do things 20 years ago is still the way to do things, even though obvioulsy it isn't always that way.

                                                  So, I am not saying a highschool drop out, with passion will make a great healer, ..... I was more trying to discuss the swollen ego that seems so prevalent with people who have large amounts of education, I am guilty of it myself on many occasions. Then again, I know people who have MD's and years of medicine under their belt, and begin to realize it doesn't make then any better then anyone else, it's a career choice. Offer everything you can to the career, and be humble and gracious about your abilities, not an ego *****.

                                                  I have one questions, what sort of opinion do you have of a songwriter, who in the mail recieves a letter, from someone who admits they had a gun to their head, and if not for listening to a certain song, they would have killed themselves, did they save a life any less then removing cancer? Or any number of other careers, that do great things..... the message of my post, was to try and have you think about how much so many people have to offer, and thinking that "the surgeon" is the most important job, because it costs the most, and takes more education then most..... is basically your way of saying everything else is lower....

                                                  I don't have a sad life, I have a problem with egotists, and from reading your posts I get this sense that you might be an egotist....... if only world was filled with more humble people. I think if you meet enough people that have been tops in their fields... (science in general) the more they do/discover and accomplish, the more they are accepting that everyone has something to offer, maybe even something life changing, because while some of the "best" are busy tooting their own horn, the little nobodies are observing, and thinking, and solving.
                                                   

                                                  stevo23

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                                                    I have a general question for current PA's that I think would belong in the current thread. Do you feel the curriculum that PA's receive (generally, I know each school is different) satisfies the interest you have in medicine and the body? I know it isn't quite the detail to which med students are educated, but just wondering if you ever ask yourself "why didn't I learn that" or "I wish we would've covered that in more detail." I'm not really worried about being the "assistant" or not having the final say. I know the PA still plays a very vital role to the healthcare team. I just want to know more about the schooling and quality of class and lab, etc. Thanks so much for any feedback.

                                                    Steve
                                                     

                                                    medtechv79

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                                                      Just because you had your mindset to go to med school and then changed it to PA is not a BAD thing. PA is not some elite thing where you're not allowed to have changed careers. So what? you wanted to go to med school then found out about PA and it fit your lifestyle better and you like it better? Then go for it! Don't let these posters deter you.
                                                      People change careers all the time. People change their minds all the time to either enter nursing, become a doctor/MD, veterinarian, etc.....Its not a bad thing and I doubt this stuff will come up in interviews. I'm sure the admissions people would love ot have more people enter this profession.
                                                      Just go for what you believe is best for you. Granted, I have heard of many people (friends, relatives) that do go the PA route b/c they couldn't do the med school route (didn't get in, fit lifestyles better) and all have gotten into PA school regardless. Please don't let these posters tell you otherwise...
                                                       

                                                      on_the_fence

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                                                        I want to work with patients and be independent, much like a doctor, but I also do not mind working on a team. I was wondering if you had any advice. If any of you were in this situation and what you did about it.

                                                        Other questions I have are:
                                                        Is it advantagous to have a PA/MPH degree over a PA degree if I am only going to practice? If I didn't want to just practice, what exactally would I do with the MPH degree?

                                                        Thanks for the advice!

                                                        Everybody works on a team -- it doesn't matter if you are a doctor, a PA, an RN, CNS, etc. If you are a doc, you just need to be more aware that you're not more important than everybody else -- your training is just more thorough.

                                                        If you are only going to practice, the MPH won't do much for you. If you want to be involved in administration, education, program design, etc. then a MPH is a good idea. It just gives you a better idea of some of the practical problems faced in the medical field and how to deal with them.
                                                         

                                                        on_the_fence

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                                                          iliketocut said:
                                                          How can you even consider yourself an equal partner with people who have more education and training than you? Don't be foolish. Physicians are "partners" with their peers, whether in a private practice or hospital setting. I wouldn't open a private practice with a "PA" I would do so with other physicians.

                                                          Please at least acknowledge that you cannot be equal partners with people who exceed you in education and training. One problem I have noticed with PA's is that they have an inferiority complex and tend to try and "compete" with physicians, which is ridiculous. I also highly doubt that if the physicians at your institution were surveyed, they would consider themselves partners with the PA's.


                                                          Why does there have to be such fierce competition in recognition between docs, nurses and PAs? In the end, they are all helping patients. I think it just ego that makes physicians to say "I'm better than you!" b/c they had more training, and they're the ultimate decision maker. Some people don't want the stress and pressure associated with medical school! Based on grades and experience, I could do med school, but I still question the lifestyle it offers. Maybe PAs are smarter than the pre-meds! :D

                                                          You may not be eqaul in terms of knowledge, but as far as being a person, doing a job that affects a person's life -- you are equal You're on a team with the people who oversee your patients, whether you meet with them once a week to discuss the patient's condition or not.
                                                           

                                                          windsurfr

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                                                            It's no different than RN's freaking out b/c legislature is considering passing bills to allow LPN's to pass/hang meds, etc...

                                                            New NP/PA's decide their future b/c they dont want as much debt, dont want as much school, want a predictible lifestyle.... where's the passion there???

                                                            It will be interesting to see where this whole thing goes. Medicine is a strange field....
                                                             

                                                            ailuj9

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                                                              Thank you all for your advice! I will be attending PA school starting in the fall at Touro University in CA. It offers a MPA and MPH. After reading all of your posts, I am pretty certain this is the right choice for me! If you have any more advice for a first year PA student, I would love to hear it!

                                                              Thank you all again! :)
                                                               

                                                              tupac_don

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                                                                on_the_fence said:
                                                                Everybody works on a team -- it doesn't matter if you are a doctor, a PA, an RN, CNS, etc. If you are a doc, you just need to be more aware that you're not more important than everybody else -- your training is just more thorough.

                                                                If you are only going to practice, the MPH won't do much for you. If you want to be involved in administration, education, program design, etc. then a MPH is a good idea. It just gives you a better idea of some of the practical problems faced in the medical field and how to deal with them.

                                                                I am sorry but the doctor is more imp than everyone else. I am not a doctor, but I do realize this fact. I mean come on, the doctor is there 30hrs+ at the hospital. The doctor makes all the important desicions, and you are telling me that he should be treated the same as the rest of the team. I mean seriously wouldn't you be a little pissed off, if you are taking care of some pt only to have someone who comes in for their 8hr shift demand to be an equal with you. Don't get me wrong I don't condone doctors to be pricks and to yell and abuse the ancillary staff. But the ancillary staff has to realize that they are ancillary and to do the best job they can without getting in the way. Really the RN's, PA's, pharmacists, PT's and all other allied health professions, should be doing their best to support the doctor and help him/her as much as possible so that they can focus on things that doctors are trained to do.

                                                                To have successful desicion making there must be a chain of command and a chain of control. Someone has to be the general and someone has to be a foot soldier.

                                                                I think what you really mean to say is that doctors should not be condescending and act superior b/c of their education. However, put yourself in their shoes. Look at the situation from their perspective. Also understand that they are sleep deprived and under stress most of the time. You can't really judge anyone until you are in that situation. Just my two cents.
                                                                 

                                                                JudoKing01

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                                                                  That's why they are called support staff. They are supposed to support the medical staff. Unfortunately, in a lot of places, the RNs, LPNs, etc., all feel like they need to prove that they aren't to be told what to do...which boggles my mind. They go into nursing to "help people," yet they make it as hard for the doctor to help the patients as legally possible while still doing the least amount of work.

                                                                  BTW, this is NOT about everyone. I know some DAMN good nurses, and I'm sure there are a lot of them. I'm just talking about the portion of them that are like what I stated above, and if you honestly think that they don't exist, you're living in a dreamworld.
                                                                   
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                                                                  adamdowannabe

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                                                                    Those of you who mention that a pharmacist and a PT are there to support the doctor....... *ahem*....... don't be ignorant, what a PT learns and does is very special to the career, out of the scope of practice of a physician......same with what a pharmacist does, very unique career.

                                                                    PA's are quite often on medical staff at hospitals, so repeatedly calling them ancillary staff is pretty wrong. Similar with some NP's.

                                                                    The careers that are really "support" staff, are the techs and nurses who do things they are told to do and theoretically make no clinical decision making without passing it through a md/do/pa for permission.

                                                                    So everyone, stop YO stupid comment making........Puhlease! Especially when you admit you don't have very much practical understanding of the matter. This thread needs to die..........but hopefully peacefully.
                                                                     

                                                                    PACtoDOC

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                                                                      adamdowannabe said:
                                                                      Those of you who mention that a pharmacist and a PT are there to support the doctor....... *ahem*....... don't be ignorant, what a PT learns and does is very special to the career, out of the scope of practice of a physician......same with what a pharmacist does, very unique career.

                                                                      PA's are quite often on medical staff at hospitals, so repeatedly calling them ancillary staff is pretty wrong. Similar with some NP's.

                                                                      The careers that are really "support" staff, are the techs and nurses who do things they are told to do and theoretically make no clinical decision making without passing it through a md/do/pa for permission.

                                                                      So everyone, stop YO stupid comment making........Puhlease! Especially when you admit you don't have very much practical understanding of the matter. This thread needs to die..........but hopefully peacefully.

                                                                      Well if you really want to get technical, a PT and a pharmacist could not exist without a physician. The opposite though is not the case. A physician can dispense meds out of their office if they go through the hassle to do such, and a good DO can do way more than a PT any day. The big problem in medicine as I see it is these professionals trying to obtain advanced doctorate degrees and then wanting to feel indespensible. Lets be serious though. What do most retail, non-compounding pharmacists do that is not considered "support"? I trust my own drug knowledge over a pharmacist's any day because I know the patient better than the pharmacist. Plus, I have the experience of actually following up thousands of patients on various medications and actually seeing the results first hand. Anything the pharmacist knows is based on a book or what a computer program algorithm tells them. Except for the rare in-hospital pharmacist, I feel that most pharmacists would fall under the umbrella of "support personnel". With the advent of the pocket PC and all the cool pharm resources we have at our fingertips, it is highly unlikely that there will be something the pharmacist picks up that we don't pick up as well. This will probably be controversial, but in my opinion you could robotize the pharm industry and get statistically better results and patient satisfaction. I mean what do you think a mail order pharmacy is anyway?
                                                                       

                                                                      bananaface

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                                                                        PACtoDOC said:
                                                                        Well if you really want to get technical, a PT and a pharmacist could not exist without a physician. The opposite though is not the case. A physician can dispense meds out of their office if they go through the hassle to do such, and a good DO can do way more than a PT any day. The big problem in medicine as I see it is these professionals trying to obtain advanced doctorate degrees and then wanting to feel indespensible. Lets be serious though. What do most retail, non-compounding pharmacists do that is not considered "support"? I trust my own drug knowledge over a pharmacist's any day because I know the patient better than the pharmacist. Plus, I have the experience of actually following up thousands of patients on various medications and actually seeing the results first hand. Anything the pharmacist knows is based on a book or what a computer program algorithm tells them. Except for the rare in-hospital pharmacist, I feel that most pharmacists would fall under the umbrella of "support personnel". With the advent of the pocket PC and all the cool pharm resources we have at our fingertips, it is highly unlikely that there will be something the pharmacist picks up that we don't pick up as well. This will probably be controversial, but in my opinion you could robotize the pharm industry and get statistically better results and patient satisfaction. I mean what do you think a mail order pharmacy is anyway?
                                                                        Non-MD/DO's are definitely support personnel. But, that does not mean the support we give is not valuble. If we had MDs/DOs trying to do all the support roles too, schooling would be way too long and the expertise that comes with specilization would not be as strong. Really, we all need each other if we are to keep the current system in place.

                                                                        As for you knowing the drugs better than a pharmacist... well, you just don't. Remember when you came to the pharm forum and were like "I bet you don't know that clindamycin can cause the dreaded PSEUDOMEMBRANOUS COLITIS!!!"? Well, I laughed really hard that day. You just have no concept of our knowledge base. Your perception borders on ridiculous.
                                                                         

                                                                        FoughtFyr

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                                                                          bananaface said:
                                                                          Non-MD/DO's are definitely support personnel. But, that does not mean the support we give is not valuble. If we had MDs/DOs trying to do all the support roles too, schooling would be way too long and the expertise that comes with specilization would not be as strong. Really, we all need each other if we are to keep the current system in place.

                                                                          As for you knowing the drugs better than a pharmacist... well, you just don't. Remember when you came to the pharm forum and were like "I bet you don't know that clindamycin can cause the dreaded PSEUDOMEMBRANOUS COLITIS!!!"? Well, I laughed really hard that day. You just have no concept of our knowledge base. Your perception borders on ridiculous.

                                                                          Yeah PACtoDOC, I'm going to have to agree with Bananaface on this one. As a resident currently on a SICU rotation I couldn't survive (nor could my patients) without the aid of the critical care pharmacist. My service includes way sick folks who might have oncologic drugs I have never heard of, might be on cardiac drugs now out of favor (I actually had a guy this week on quinidine and mexiletine), and/or might have abnormal distributions (what effect does an open and packed abdominal wound have?) among other issues. So, when I'm faced with RSIing a patient on trimethylbadstuff, I kind of rely on the CC pharm to keep me out of trouble. And if I am writing for pain control, abx, and sedation on a patient who is mid-stream of some bizarre oncologic therapy, it is good to have a pharmD at my back.

                                                                          You'll learn soon enough that you will NEVER know drugs as well as they do! I grant you, they need us too, they are not doctors, but your assumption that they are not important is simply wrong. I look at them the same way a race car driver looks at a pit crew chief. I could do most of what the pit crew chief does, but probably not as well. And I can't do it while driving the car. So, I'll hire the best crew chief I can and rely on them to keep the car running so I can do my job. Without me, they have no job, but without them, I can't do mine well.

                                                                          - H
                                                                           

                                                                          PACtoDOC

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                                                                            bananaface said:
                                                                            Non-MD/DO's are definitely support personnel. But, that does not mean the support we give is not valuble. If we had MDs/DOs trying to do all the support roles too, schooling would be way too long and the expertise that comes with specilization would not be as strong. Really, we all need each other if we are to keep the current system in place.

                                                                            As for you knowing the drugs better than a pharmacist... well, you just don't. Remember when you came to the pharm forum and were like "I bet you don't know that clindamycin can cause the dreaded PSEUDOMEMBRANOUS COLITIS!!!"? Well, I laughed really hard that day. You just have no concept of our knowledge base. Your perception borders on ridiculous.

                                                                            I am sure it is easy to learn that PMC is caused by many antibiotics, but when you don't get to be the one physically taking care of the patient who has said disease, your knowledge becomes as stagnant as the book you learned it from. And perhaps you could show me that old post since I don't remember it. Something tells me you are taking someone's words out of context. But since this is not the pharm forum, I feel completely comfortable knowing my pharm knowledge is the knowledge necessary to provide patient care. To pharmacists, the world of medicine is black and white with no shades of gray. A pharmacist gets all worked up when they hear a patient on an ACE has a creatinine level of 2.5, but then again they have no experience treating renal failure. I can't tell you how many times in my life I have been called by a pharmacist worried over my prescribing a cephalosporin to someone with a PCN allergy. What pharmacists are not trained in are all the intricate patient management decisions that violate the sacred black and white rules. I do appreciate when I have a good pharmacist willing to get on the phone and talk with me about a patient issue, but more times than not I am simply asked to press "1" to speak to a member of the pharmacy staff, and then left to be on hold for all eternity.
                                                                             

                                                                            PACtoDOC

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                                                                              FoughtFyr said:
                                                                              Yeah PACtoDOC, I'm going to have to agree with Bananaface on this one. As a resident currently on a SICU rotation I couldn't survive (nor could my patients) without the aid of the critical care pharmacist. My service includes way sick folks who might have oncologic drugs I have never heard of, might be on cardiac drugs now out of favor (I actually had a guy this week on quinidine and mexiletine), and/or might have abnormal distributions (what effect does an open and packed abdominal wound have?) among other issues. So, when I'm faced with RSIing a patient on trimethylbadstuff, I kind of rely on the CC pharm to keep me out of trouble. And if I am writing for pain control, abx, and sedation on a patient who is mid-stream of some bizarre oncologic therapy, it is good to have a pharmD at my back.

                                                                              You'll learn soon enough that you will NEVER know drugs as well as they do! I grant you, they need us too, they are not doctors, but your assumption that they are not important is simply wrong. I look at them the same way a race car driver looks at a pit crew chief. I could do most of what the pit crew chief does, but probably not as well. And I can't do it while driving the car. So, I'll hire the best crew chief I can and rely on them to keep the car running so I can do my job. Without me, they have no job, but without them, I can't do mine well.

                                                                              - H

                                                                              I NEVER said they were not important. And if you read my posts without starting typing first, you will see that I have stated many times that hospital based pharmacists are a different breed. And spare me the down talk youngin. I was speaking fluent medicine when you were still a frat geek. Don't take my comments out of context please. But between you, me, and the wall, we all know that the number of pharmacists who are capable of functioning on a team like that are few and far between. But the ICU is not the real world of medicine. It is a small isolated place where experience rules no matter what your title is. I know RN's and PA's that routinely have to hold the resident's hands there because it can be so overwhelming when you first become exposed to it. Yes pharmacists are valuable. But yes, much of what they do outside a hospital could be done by the tech, and is.
                                                                               

                                                                              PACtoDOC

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                                                                                bananaface said:

                                                                                Look at the title of that thread. It was a rant by pharm students trying to vie for script priviledges as pharmacists. It needed to have an opposing viewpoint thrown in there, and thus my comments were only in reply to some very uneducated comments stated by the pharm people. If you scroll back a few posts from that one, you will read the idiotic comments that deserved such a stance. They were casually acting as if prescribing clindamycin was no big deal. My question was entirely valid to the population of people talking on that thread.

                                                                                Its funny you never see these types of threads started on the mainstream medical forums. Its because you know you will always get the same sort of response. And just as I presumed, you took the comments I made and twisted them to fit your thesis. Good try, but anyone with a brain can read the surrounding posts and see that what I said made perfect sense.
                                                                                 

                                                                                bananaface

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                                                                                  PACtoDOC said:
                                                                                  Look at the title of that thread. It was a rant by pharm students trying to vie for script priviledges as pharmacists. It needed to have an opposing viewpoint thrown in there, and thus my comments were only in reply to some very uneducated comments stated by the pharm people. If you scroll back a few posts from that one, you will read the idiotic comments that deserved such a stance. They were casually acting as if prescribing clindamycin was no big deal. My question was entirely valid to the population of people talking on that thread.

                                                                                  Its funny you never see these types of threads started on the mainstream medical forums. Its because you know you will always get the same sort of response. And just as I presumed, you took the comments I made and twisted them to fit your thesis. Good try, but anyone with a brain can read the surrounding posts and see that what I said made perfect sense.
                                                                                  I reread the entire thread before posting the link. I'm that good. ;)

                                                                                  I truly hope that you learn to appreciate and respect support staff during your rotations and residency.
                                                                                   

                                                                                  FoughtFyr

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                                                                                    PACtoDOC said:
                                                                                    And spare me the down talk youngin. I was speaking fluent medicine when you were still a frat geek.

                                                                                    Given that I was never a "frat geek" and that I have been in medicine as a firefighter and paramedic since 1990, I find that hard to believe. Many others besides you have been there and done that. Young 'un my a$$. Maybe if you spent more time learning and less time pontificating on your vaunted age and experience, you'd get along better with the support staff.

                                                                                    - H
                                                                                     

                                                                                    PACtoDOC

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                                                                                      FoughtFyr said:
                                                                                      Given that I was never a "frat geek" and that I have been in medicine as a firefighter and paramedic since 1990, I find that hard to believe. Many others besides you have been there and done that. Young 'un my a$$. Maybe if you spent more time learning and less time pontificating on your vaunted age and experience, you'd get along better with the support staff.

                                                                                      - H

                                                                                      I suggest if you are really an intern or resident, you should not worry about my opinions and instead move on to more important issues affecting you. You have no idea who I am or how I function in the real world. I get along great with all the support staff, when they do not attempt to be more than support staff. I am glad though that you just experienced that Freudian slip though because thats all I was trying to say myself. Pharmacists are support staff. Again thank you for saying it. Undoubtedly there are some incredible support staff out there. I come from many a former profession that was full of them.
                                                                                      Corpsmen--->EMT-B---->LVN--->EMT-P--->PA-C---->physician.
                                                                                      But never did I once advocate that any of the professions I was in before now should be independent, should encroach on physician practice, or be anything other than a partner in medicine. If you were hoping that myself and all others in the medical world would be passive while a group of pharmacists vied for script priviledges, then you would be irrational. You of all people should understand this DOCTOR! Its never the incredible performers in the allied health world that threaten physicians. Its instead their lobbyists and professional organization leaders who make these broad sweeping policy changes that attempt to encroach on medicine. Then it makes the whole profession adversaries over night. But you cannot judge a profession's professional abilities based on a few stellar performers you have seen in the hospital. That is not where most pharmacists exist. And although I would argue that you could probably make a very competent prescribing pharmacist out of most hospital based pharmacists, we all know that the retail pharmacist down at CVS will benefit from the same policy change. And then you have retail pharmacists prescribing, and that my friend is not going to help increase the quality of patient care. Thats all I was trying to say. Don't judge how I interract with my peers because you are not here with me to see my everyday functions. This is an internet forum where opinions on various issues are not only necessary for the forum's existence, but encouraged. If you don't like what I am saying, then argue against it with tact and point. I have yet to hear anything come from your verbage that shows a credible argument for what I am saying. You just keep saying the same old thing about how "PACtoDOC doesn't respect support staff". Enough with that man, lets stick to the facts or lets just stop talking about it. My point is obvious. My thesis does not need to be restated, but I will for clarity. Pharmacists are valued members of the healthcare team and are important members of the support staff in medicine. However, they are not physicians, and give them any degree you choose, but it should not and will not change their role as support staff. They should not be prescribing under any circumstance, and they should not be giving non-medication advice. If that offends someone, then I suggest you send your comments to the AMA and AOA, because what I have just stated, and stated many times before this, is the same official policy that comes from them on this issue.
                                                                                       

                                                                                      primadonna22274

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                                                                                        I heartily concur. This is exactly why I am returning to school to become an MD...I need to be the leader. I've been a good team player for a long time but I'm already at the limit of what I can do (in primary care anyway) and I want the flexibility to learn and do more.
                                                                                        I didn't go to med school initially because my priorities were skewed (ex-husband, bah) but I've found I'm unfulfilled as a PA. I think the happiest PAs I know are basically content people, content being a part of the team, knowing they are ultimately not the end of the line when it comes to patient responsibility. As a PA, I'm responsible for what I do, but so is my supervising physician, and he could conceivably limit my scope of practice as he sees fit, should he wish to do so. Thankfully I'm in a comfortable work situation where that doesn't happen and my people skills and experience are valued.
                                                                                        But if teamwork appeals to you, PA's a good route. It's not for everyone, anymore than being an MD is for everyone. For myself, I've realized that I can interview, examine, diagnose and treat people just as well or better than any of the MDs I've worked with, and there's no good reason I shouldn't become one if I'm willing to work as hard as they did.
                                                                                        For the record, PA school isn't easier...it's just shorter. It's still an amazing feat, and not for the faint of heart or soul. Perseverance is the key--you stick to it, day after day, even when you're tired and sick and poor.
                                                                                        Lisa PA-C (applying to MD 2006)

                                                                                        iliketocut said:
                                                                                        I wanted to post on this thread to correct some misperceptions. It is uneducated and incorrect to even compare a PA to an MD. Becoming a physician requires a tremendous amount of sacrifice (time-wise, financial, emotional, etc.) It is a long, but rewarding road and at the end of it, you know that you are the ultimate leader of the healthcare team. Your patients put their lives and trust in your hands and look to you to make them better.

                                                                                        PA's, while intelligent and valuable, are considered "ancillary staff" just as nurses and NP's are. They are, as their title suggests, "physician ASSISTANTS" and they assist the medical team in caring for the patient. They are not, however, the ultimate decision makers and they do not have the opportunities that physicians do.

                                                                                        While PA's are very valued, I think that if you asked any of us (MD's) we would not trade places with them for anything. You must decide what the right path is for you and pursue it. But please do not have any illusions about what your role will be and please don't think that you will be in any way eqivalent to a physician. It is like comparing apples and oranges.
                                                                                         

                                                                                        LAZYGUY

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                                                                                          bananaface said:
                                                                                          I'd rather ask why nitro groups are avoided in drug design. :p


                                                                                          nitro groups act as an "electron sink" that damage DNA b/c they can form toxic intermediates as a result of being reduced inside the cell



                                                                                          Personal opinion about the whole MD vs PA debate: If we all had the same training it would suck for the patient right? No one person and no one field can cover the VAST amount of care that the populace needs. Isn't it good to know that we all have different training to do just that? Whether it be changing the bed pan, assisting physicians or performing surgery, let us not forget that we all have a role in the care of our pts.

                                                                                          I have no trouble learning from others if it helps me be a more competent physician. Let us put our egos aside and concentrate on what really matters.
                                                                                           

                                                                                          adamdowannabe

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                                                                                          5+ Year Member
                                                                                            The thing about comparing any other career besides PA to that of physician, is the whole apples/oranges cliche, each career, (nursing, pharm, pt, emt-p) is taught things a physician isn't.....plain and simple,

                                                                                            But, a PA education on the other hand is all the most practical and applicable stuff one might learn in medical school. Without all the intrinsics, a PA learns medicine at the minimalist level. what to look for, how to fix it. I am sure it takes a PA lots of years of on the job learning to know pathophysiology similar to what a med student gets force fed during med school and studying for step I. The great thing about the PA model, is the really detailed info one learns in medical school is only usefull occassionally, 90% of medicine is pretty typical, seen it 1,000 times, sort of thing, it's that 10% where the importance of having the more extensive physician education comes into play. I am sure there are many physicians, who spend their whole career and never come across a case that a PA couldn't handle as informed and as effectively as a physician, but just in case something abstract, unique, and oddly presenting shows up (a shetland pony!), a good medical education is needed to trouble shoot; to use the basics to piece together a diagnosis and a plan, that knowledge a PA wouldn't have learned in school, and unless they are geeky and read physiology and pathophys books on their time off, they probably haven't learned it on the job either. Thats the separation of PA vs. MD, that and a PA didn't have to hustle and be the b!tch for an intern year unless they chose to....

                                                                                            Funny thing about the argument, physicians continually yelling about how PA's can't possibly know as much as themselves, and how unless they go to medical school won't ever be anything but a mere assistant, these physicians on SDN are probably insecure, because in reality you can take anybody and have them read medical text and learn this stuff, (well, anybody with normal intelligence) A PA falls into this category too (along with the 165IQ science types creating all the great medical technology that most Dr.'s can't begin to explain the workings of) and unlike random people reading the book, and learning the stuff, a PA gets to see it and diagnose it too. (practical application...kind of like rotations and residency!) So, theoretically a PA has all practical application oppurtunity....just lacking the text book info to apply.

                                                                                            At the rate of travel at which the PA profession is currently at, in the next 8-10 years, it's going to be a whole different thing to be a PA, it won't be the unknown career, and more an more PA's will be in partnership with physicians (obviously a 49% ownership partnership)

                                                                                            By nature, a PA in most states has the ability to have the exact same scope of practice as their physician supervisor (sans being the man with the knife) so, unless being a surgeon, is your thing, there is little as a PA you can't learn and be able to do. And there are PA's doing it.

                                                                                            And here is where all the MD's and DO's will return fire with the idea that the PA can never know what a Dr. knows, and will never be as good as someone who went through medical school. And, like I said above, a PA can read all the same text books you read in medschool, and can turn to their Dr. colleagues and ask questions about complicated pathophys and actuallly gosh darn it, learn the sh!t, although it probably rarely happens, and people who do want to gain this information think to themselves...." If I am going to learn it, I might has well spend 7 years learning it, then at least when my patients call me their Doctor, I don't have to correct them!" and then they go to medical school!

                                                                                            And then they come to SDN to tell everyone that PA's are good but don't know as much as physicians, uh, DuH?

                                                                                            I think most of this debate is really about people who like the idea of being a PA and the certain freedoms it allows, but would rather go to medical school, then have to deal with physicians who look at and treat PA's like second class citizens of the medical world, and in not such direct ways put PA's "in their place" ..... it's hard for someone who could go both routes (based on grades and test scores etc)to knowlingly seal their fate to a life of being treated badly by some physician with an attitude, so they want confirmation about what being a PA is like (hoping to have some NICE comments posted), and unfortunatley on SDN it's seems most of the reponses come from people who want to use an anonymous thread to reign superiority over the PA's by proclaiming "I am DOCTOR"...... All I ask, is for more humility in medicine. Ego driven physicians give the nice ones a bad name. Stop it!
                                                                                             

                                                                                            toughlife

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                                                                                              adamdowannabe said:
                                                                                              The thing about comparing any other career besides PA to that of physician, is the whole apples/oranges cliche, each career, (nursing, pharm, pt, emt-p) is thought things a physician isn't.....plain and simple,

                                                                                              But, a PA education on the other hand is all the most practical and applicable stuff one might learn in medical school. Without all the intrinsics, a PA learns medicine at the minimalist level. what to look for, how to fix it. I am sure it takes a PA lots of years of on the job learning to know pathophysiology similar to what a med student gets force fed during med school and studying for step one. The great thing about the PA model, is the really detailed info one learns in medical school is only usefull occassionally, 90% of medicine is pretty typical, seen it 1,000 times, sort of thing, it's that 10% where the importance of having the more extensive physician education comes into play. I am sure there are many physicians, who spend their whole career and never come across a case that a PA couldn't handle as informed and as effectively as a physician, but just in case something abstract, unique, and oddly presenting shows up, a good medical education is needed to trouble shoot; to use the basics to piece together a diagnosis and a plan, that knowledge a PA won't have learned in school, and unless they are geeky and read physiology and pathophys books on their time off, they probably won't have learned it on the job either. Thats the separation of PA vs. MD, that and a PA didn't have to hustle and be the b!tch for an intern year unless they chose to....

                                                                                              Funny thing about the argument, and physicians continually yelling about how PA's can't possibly know as much as a themselves, and how unless they go to medical school won't ever be anything but a mere assistant, these physicians on SDN are probably insecure, because in reality you can take anybody and have them read medical text and learn this stuff, (well, anybody with normal intelligence) A PA falls into this category too (along with the 165IQ science types creating all the great medical technology that most dr.s probably don't know how it works) and the unlike random people reading the book, and learning the stuff, a PA gets to see it and diagnose it too.

                                                                                              At the rate of travel at which the PA profession is currently at, in the next 8-10 years, it's going to be a whole different thing to be a PA, it won't be the unknown career, and more an more PA's will be in partnership with physicians (obviously a 49% ownership partnership)

                                                                                              By nature, a PA in most states has the ability to have the exact same scope of practice as their physician supervisor (sans being the man with the knife) so, unless being a surgeon, is your thing, there is little as a PA you can't learn and be able to do. And there are PA's doing it.

                                                                                              And here is where all the MD's and DO's will return fire with the idea that the PA can never know what a Dr. knows, and will never be as good as someone who went through medical school. And, like I said above, a PA can read all the same text books you read in medschool, and can turn to their Dr. colleagues and ask questions about complicated pathophys and actuallly gosh darn it, learn the sh!t, although it probably rarely happens, and people who do want to gain this information think to themselves...." If I am going to learn it, I might has well spend 7 years learning it, then at least when my patients call me their Doctor, I don't have to correct them!" and then they go to medical school!

                                                                                              And then they come to SDN to tell everyone that PA's are good but don't know as much as physicians, uh, DuH?

                                                                                              I think most of this debate is really about people who like the idea of being a PA and the certain freedoms it allows, but would rather go to medical school, then have to deal with physicians who look at PA's like second class citizens of the medical world, and in not such direct ways put PA's "in their place" ..... it's hard for someone who could go both routes (based on grades and test scores etc)to knowlingly seal their fate to a life of being treated badly by some physician with an attitude, so they want confirmation about what being a PA is like (hoping to have some NICE comments posted), and unfortunatley on SDN it's seems most of the reponses come from people who want to use an anonymous thread to reign superiority over the PA's by proclaiming "I am DOCTOR"...... All I ask, is for more humility in medicine. Ego driven physicians give the nice ones a bad name. Stop it!


                                                                                              I have worked with PAs in rotations and have found them to be nice people over all. One of my med school classmates is a PA and he is a great guy as well. For some reason PAs seem nicer and easier to work with than NPs. Dunno why that is.
                                                                                               
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