How old are you?
How much do you like school?
How likely are you to realize that the most important things in life are free, and waiting for you at home (wife and kids)?
It depends on who you are and who your wife is, and what you wanted from your family life.
PA school is just as intense as med school, it's just more "condensed." The studying doesn't end when you leave school, either, because there's a very steep learning curve your first year out of your PA program. After that, you learn at the pace of any resident in the field you've chosen, perhaps a LITTLE slower since you often have more clinical responsibilities they're paying you to accomplish (see patients, do the cases, not take classes/conferences with the residents--though you will go to your fair share of conferences, of course).
As a surgical PA, there will always be some things you "can't" do, because of liability or the nature of the field. However, you will have been in and out of school in 27 months or less, and making 60-80k (depending on your chosen field) sooner rather than later. If you do MD you'll have to wait 4 years to make even 40k as a resident, and work many more hours during residency than a PA would work in their actual job (generally).
Ask yourself what's right for you, but also ask yourself what's right for your wife and kids. Is she willing to support you and raise the kids while you're gone a lot of the time for med school and residency? Or did she think you were going to be an elementary school teacher before the medicine-bug bit you?
Was she envisioning a family life where the two of you had equally important (time, money, stability, earning potential) careers and split childcare and household chores completely down the middle?
I'm not trying to say it's impossible to be a physician and have a family at all--because many docs do it. I'm saying that is *does* change the family dynamic somewhat, unless you work VERY hard to organize your professional life around your family. That is doable, but less-so in surgery than other fields (radiology, dermatology, even psych or family practice or emergency med can be conducive to family life if you're smart about it). Surgery is a tough field--it's competitive, it's long hours, stressful, etc. Sure, most surgeons you poll will tell you they have a great family life. But they're SURGEONS. They knew it was long, grueling, and stressful, and they still wanted to pursue it--so you reap what you sow, right? I wonder if anyone out there is polling the surgeon's kids to see if mommy and daddy spend enough time taking them to ball games. Be careful of the flip side.
I was in PA school for a couple semesters, and I realized it wasn't right for me. I wanted a deeper exposure to the medicine, a chance to spend more time and effort on the material and on the transformation from lay-person to healthcare practitioner. My wife and I didn't have kids, though we had both planned to do masters degrees and then enter the workforce; she was gracious enough to understand my dilemma/depression with being where I didn't want to be, and she was very supportive of my desire to go to med school... eventually. After I convinced her I wanted it for the right reasons, and still had a committment to the family life she and I had both dreamt of (phew, after THAT interrogation, medschool interviews were a breeze!).
Good luck to you, whatever you choose. But do remember that your current life situation demands that you make a choice not only for yourself, but for your wife and kids, too. If med school is what you want, do yourself a favor and be completely honest with yourself and your family about why you want it. Help your wife understand that you're not turning your back on the way things were "supposed to be" for you guys, or the way things were going to be. That was very important for my wife when we made the decision that med school was the right path for me.
