Physician Assistant, a pre-med interested in PM&R

[Challenge]

Hello, First, let me introduce myself that I am not even a med student nor resident/fellow/physician but a Physician Assistant who is also a pre-med interested in PM&R specialty.. I'm a passionate holistic believer as well as Emergency Medicine PA working in academic setting in a major city. I am planning on applying to osteopathic medical school in the next few years.

Long story short, I have been EM-PA for almost 2 years now after being eternal student going through several colleges, graduate programs and taking different jobs. Because I am old pre-med in my mid 30's with other life experience (plenty of mistakes in the past), I really want to make a right decision this time once and for all. In addition, I am more prudent than ever in making a decision about my future career in medical field.

Given high stress of working in the ED as a PA - dealing with rude condescending consultants who like to shoot the messenger, seeing drug seekers, crazies, drunk, violent and demanding patients, and only being able to prescribe med (narcotic mainly) for pain in the ED for anxious patient in chronic pain, working days and nights..etc - I no longer find working in the ED interesting even though it can be rewarding and exciting on occasion.

So I stumbled upon PM&R specialty and I am starting to find that finally I am hoping this is the field I want to be in for the rest of my life. However I don't have desire to quit my ER job and switch to PM&R or neuro/ortho as I find my current job very valuable medical experience so far. (In fact, I deal with so many MSK/neuro/ortho cases in the ED)

When I become a physician, I really want to work in a less stressful, laid back environment, dealing with diverse issues and multidisciplinary "friendly" approach practice. I also like the continuity of care aspect, non-narcotic, holistic approach to patient care combined with interventional procedure to treat patients with chronic pain.


Although I have not done any single rotation or shadowing experience with PM&R field, I think have done enough research that I can see myself working in outpatient setting practicing PM&R plus interventional spine +/- pain/sports med.

I am about 95% convinced that I should pursue PM&R but I still need opinion/advice from those who are already practicing PM&R as resident or physician. Any pros and cons to this specialty? Again I try not to have the sense of "grass is greener on the other side" as I truly know what I want in life. I would appreciate any input/insight to this. Thanks

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[shantster]

Any reason why you don't want to just get a job in a PM&R office as a PA? If your goal is to

work in a less stressful, laid back environment, dealing with diverse issues and multidisciplinary "friendly" approach practice. I also like the continuity of care aspect, non-narcotic, holistic approach to patient care combined with interventional procedure to treat patients with chronic pain

you would be better served just working as a PA. Then you would be working in the practice and not having to do call, inpatient, etc. Going through medical school and residency is not all rosy that you picture it being. Nothing in your post explains why you want to go into medical school and be a doctor rather than be a physicians assistant, which is a question you will have to answer in the PS and will be asked many times during the interviews.

 

[Challenge]

Any reason why you don't want to just get a job in a PM&R office as a PA? If your goal is to you would be better served just working as a PA. Then you would be working in the practice and not having to do call, inpatient, etc. Going through medical school and residency is not all rosy that you picture it being. Nothing in your post explains why you want to go into medical school and be a doctor rather than be a physicians assistant, which is a question you will have to answer in the PS and will be asked many times during the interviews.

The main point of my post wasn't about why medical school not PA. I understand why you would be curious. However I won't get into detail. I can answer that in many legitimate ways. (There are pros and cons of being PA as there are pros and cons of being Physician)

I am already passed that point. I guess I chose med school for similar reason why pre-med wants to go to medical schools and not PA.
Now I don't regret being a PA since this will be my unique pathway to success in medical field.
Yes I know medical field is definitely not glamorous.
I also witnessed what physician/medical student/residents are going through.
In fact I am close to MANY who are already attendings/residents so I know what I am getting into.

I just want deeper insight on PM&R. I believe it's very different from EM.

 

[Jitter Bug]

PM&R offers diverse practice opportunities. You can work in a big hospital and run a unit full of sick people and do consults, or you can do outpatient, or get into oddball areas like O&P (orthotics and prosthetics) or EMG's. You can end up working nights and weekends or get a 9-5 M-F gig.

The stress in PM&R comes from the newly injured patients. Being calm in the storm for a newly paralyzed 17 year old girl and her hysterical mom, dad, brother, grandma, grandpa and uncle Phil can be emotionally draining. Having them take out their anger and fear on you because it has to go somewhere. But it can be rewarding when you can show them the way to move on from catastrophe.

I would give you the same advice for whatever medical field you were interested in. Go to PM&R lectures. Get a PM&R mentor to meet for lunch or shadow for an afternoon. And do your PM&R rotations early when you start your clerkships. Be open to the idea that you may likely change your field of interest at least 10 times during your 4 years of medical school. I started med school convinced I was going into infectious diseases, and finally ended up happily in PM&R after seriously considering several other fields.

 

[Challenge]

PM&R offers diverse practice opportunities. You can work in a big hospital and run a unit full of sick people and do consults, or you can do outpatient, or get into oddball areas like O&P (orthotics and prosthetics) or EMG's. You can end up working nights and weekends or get a 9-5 M-F gig.

The stress in PM&R comes from the newly injured patients. Being calm in the storm for a newly paralyzed 17 year old girl and her hysterical mom, dad, brother, grandma, grandpa and uncle Phil can be emotionally draining. Having them take out their anger and fear on you because it has to go somewhere. But it can be rewarding when you can show them the way to move on from catastrophe.

I would give you the same advice for whatever medical field you were interested in. Go to PM&R lectures. Get a PM&R mentor to meet for lunch or shadow for an afternoon. And do your PM&R rotations early when you start your clerkships. Be open to the idea that you may likely change your field of interest at least 10 times during your 4 years of medical school. I started med school convinced I was going into infectious diseases, and finally ended up happily in PM&R after seriously considering several other fields.

Jitter Bug-> Thank you that was very helpful. I'm glad you are finally happy in PM&R. I hope my EM skills will be useful in dealing with "stormy situation" and/or critically ill patients. I deal with craziness everyday in the ED. I realized there is PM&R residency program at our medical center in NYC.
I will contact PD for shadowing opportunities.. Thanks

 

[PMR 4 MSK]

Given high stress of working in the ED as a PA - dealing with rude condescending consultants who like to shoot the messenger, seeing drug seekers, crazies, drunk, violent and demanding patients, and only being able to prescribe med (narcotic mainly) for pain in the ED for anxious patient in chronic pain, working days and nights..etc - I no longer find working in the ED interesting even though it can be rewarding and exciting on occasion.
...

When I become a physician, I really want to work in a less stressful, laid back environment, dealing with diverse issues and multidisciplinary "friendly" approach practice. I also like the continuity of care aspect, non-narcotic, holistic approach to patient care combined with interventional procedure to treat patients with chronic pain.

In PM&R, we deal daily with condescending consultants - PM&R suffers greatly from a lack of respect from other specialties. So that won't change for you.

We get drug-seeking, crazy and demanding patients, but can usually avoid the drunk and violent ones. However, your traumatic brain injury patients will be all that rolled into one pt. The spinal cord injury patients are often the same.

We typically have stress in different ways. It is rare that we need to make immediate decisions or someone will die. Instead, it's the lack of tools to "fix" our patients suffering from chronic pain or disability.

You will also bring on the stress of being a physician - more responsibility at a time when the public and government are making the practice of medicine much more difficult and far less rewarding, financially or personally.

The key here is to keep your mind and your options open. You may decide over the next few years that there is a different field of medicine that you are attracted to. Good luck to you.

 

[Challenge]

Thanks for the advice.