Physician Assistant

[etjaipleure]

I was wondering...does anyone know if you get a masters of science as a physician assistant in cardiothoracic surgery, if you wanted to go for a doctor of medicine, do you still have to go for the full four years, then do a residency? I was just wondering because a PA would already have clinical experiences and medical experience and I was just wondering if they would make you go the full time in med school. I'm getting my PA soon and I'm not sure whether I want to continue after that, but I was thinking about going in to radiology. I wanted to become a PA so I can get some experience first and then think about whether I wanted to continue to become a doctor.

---

Members don't see this ad.

 

[SupergreenMnM]

There is another (recent) thread about this I would suggest you go look at. Short of story is if you are a PA, a nurse, a PhD, a Paramedic, etc. you did not get trained in medical school and will need to take MCATs and do 4 years of school + residency; nothing you have done to date compairs with any of that, as you will soon find out if you do decide to go

 

[Haemulon]

There is another (recent) thread about this I would suggest you go look at. Short of story is if you are a PA, a nurse, a PhD, a Paramedic, etc. you did not get trained in medical school and will need to take MCATs and do 4 years of school + residency; nothing you have done to date compairs with any of that, as you will soon find out if you do decide to go

Agreed.

 

[Dr JPH]

I was wondering...does anyone know if you get a masters of science as a physician assistant in cardiothoracic surgery, if you wanted to go for a doctor of medicine, do you still have to go for the full four years, then do a residency? I was just wondering because a PA would already have clinical experiences and medical experience and I was just wondering if they would make you go the full time in med school. I'm getting my PA soon and I'm not sure whether I want to continue after that, but I was thinking about going in to radiology. I wanted to become a PA so I can get some experience first and then think about whether I wanted to continue to become a doctor.

Prior training as a PA, NP or any other mid-level doesnt give you a "get out of med school free" card.

You will still need to go through a full residency as well, regardless of your prior training.

 

[trainride]

First of all I don't believe you when you say you are "getting your PA soon" You typically don't get a PA degree in a specialty. There are surgery PA programs but you don't specify what what field you are going into prior to graduating. This is what makes PAs so much more valuable than NPs. PAs are educated like a doctor and can therefore be trained to work like the doctor prefers. Along these lines PA school is the same basic medicine a doctor gets minus biochemistry. Only PAs have to do it in only 15 months instead of two years that we get. So if you think about it this way their years in class might be harder than ours. Granted they have no residency and their rotations are not what doctors get but they work extremely hard to become a PA. They also pay a lot >100K for 27 months. Therefore, why would you put yourself into so much debt when ultimately your PA degree would be useless. MD and PA are completely different careers. You should have known that before you start(ed) the long path to becoming a PA. So unless you totally hate your role as a midlevel provider you should stick with PA until you are totally sick of doing what your employer (doctor) tells you to do.

 

[Law2Doc]

Along these lines PA school is the same basic medicine a doctor gets minus biochemistry. Only PAs have to do it in only 15 months instead of two years that we get. So if you think about it this way their years in class might be harder than ours.

LOL. I was with you on your post until you tried to suggest PA school was harder than med school. It's hard, but certainly not harder.

Med school has really just 20 months of course work (Aug thru May times two), and biochem is not an insignificant course, so it's probably not a huge difference in actual months when you adjust for lack of that course. (Even if you assume that is the only difference, which it is not -- FWIW, some of the PA's I have known while in grad school did not really cover exactly the same material or level of detail as in med school, based on their text books.) But more importantly, a big portion of what makes med school hard is Step 1 looming at the end, and the fact that you are competing in rank with other med students. The real learning in medicine comes after the basic science years, during your rotations and residency, though. Everything before is just foundation.

 

[Dr JPH]

PA school has a rough curriculum.

Of course, it goes against the nature of a medical student to admit that something other than medical school may be academically challenging.

 

[Haemulon]

PA school has a rough curriculum.

Of course, it goes against the nature of a medical student to admit that something other than medical school may be academically challenging.

I agree, in part. From what I understand it really is a tough curriculum. But one of the earlier posts almost seemed to imply that it was actually harder than med school. This strikes me as a round about way of suggesting that getting an MD easier than becoming a PA, but just takes longer. Even if we ignore the clerkships and internship/residency. There are differences in depth of detail covered in the subject areas of the first 2 years. And as was mentioned earlier, USMLE is a huge part as well.

 

[Law2Doc]

Of course, it goes against the nature of a medical student to admit that something other than medical school may be academically challenging.

It wasn't a med student who drew first blood and suggested their program was "harder". The PAs are the ones violating nature here. (Sounds kinky).

 

[trainride]

But more importantly, a big portion of what makes med school hard is Step 1 looming at the end, and the fact that you are competing in rank with other med students.


I agree with you. Waiting for step 1 is extremely intimidating. Especially when just 1 pt. can affect your rank so dramatically. The PAs do take a pretty significant board certification test that is very difficult. From what I can tell it covers much of the same material as step 1 (speaking from partial ignorance bc not 100% sure what is on step 1). Therefore, if you can work through and ignore the pressure of step 1 the experience would be similar. Their is pressure on PAs to atleast pass the test so that they can work. The good thing about PA is they are done after that. Fine skip residency and all that is good and bad about it. Make 60-100K/yr. However, know for the rest of your employment future you have to do and practice how the doctor you work for (with) says. PAs can do anything a doctor does (minus make the first incision in surgery) if the doctor lets them. See their own patients if the doctor reviews approximately 10%, prescribe if the doctor oversees them. It can be a sweet life if you don't mind working under someone. Personally I would rather go through the hardship of residency for 3-7 years and be my own boss.

 

[Law2Doc]

Waiting for step 1 is extremely intimidating.

"Waiting" has nothing to do with it. That's the easy part.

 

[Haemulon]

(snip) ... PAs can do anything a doctor does (minus make the first incision in surgery) if the doctor lets them. See their own patients if the doctor reviews approximately 10%, prescribe if the doctor oversees them. It can be a sweet life if you don't mind working under someone. Personally I would rather go through the hardship of residency for 3-7 years and be my own boss.

You know, I definitely not an expert on this. But I hardly think that the scope of the MD and PA practice is the same, (assuming that the MD lets the PA do everything). The skill sets are not even remotely comperable because most of the advanced treatment and diagnostic techniques are learned/mastered through residency training. And note that I am not talking about day to day primary care here.

 

[trainride]

If it was easy everyone would be a doctor.

 

[Critical Mass]

When I saw the title, I thought, "Oh no, flame war coming."

Then when I read the OP, I thought, "Oh, this guy is just misinformed. This won't be too bad."

Then somebody wants to talk about how "hard" something is compared to medicine. I was right the first time.

PA school is shorter but clinical experiences begin sooner. It is challenging, and indeed I am well known as the SDNer who was rejected to PA school at the same institution where I was easily accepted to medical school. They are separate career paths, so there is no way around med school if you want to be a DO or MD.

If you don't have the numbers, medical schools won't take you because while clinical experience is important to medicine, it is not correlated with a solid USMLE I (still the primary indicator of matching success).

Going through a PA program is a pretty expensive way to figure out if medicine is right for you.

 

[Haemulon]

If it was easy everyone would be a doctor.

Agreed. And our pay would be crappier

 

[trainride]

You know, I definitely not an expert on this. But I hardly think that the scope of the MD and PA practice is the same, (assuming that the MD lets the PA do everything). The skill sets are not even remotely comperable because most of the advanced treatment and diagnostic techniques are learned/mastered through residency training. And note that I am not talking about day to day primary care here.

This is true. You would not want to throw a new grad PA into a practice and give them full autonomy. However, as a doctor becomes more comfortable with a PA's skills it is not uncommon for them to be very much on their own. I believe in surgery PAs function more as a first assistant but in seeing clinic patients they can be taught (after graduating) how to practice like the doctor.

 

[psipsina]

You know, I definitely not an expert on this. But I hardly think that the scope of the MD and PA practice is the same, (assuming that the MD lets the PA do everything). The skill sets are not even remotely comperable because most of the advanced treatment and diagnostic techniques are learned/mastered through residency training. And note that I am not talking about day to day primary care here.

In my (very limited) experience, the midlevels are given the routine stuff to deal with so the doc has more time for the cases that are more challenging (read: interesting). Whenever something ventures beyond routine the midlevels have to go to the doc for advice on what to do, or hand over the case. I'm sure if an individual was particularly capable they would be given more responsiblilty.

For many of us its the complex, problem solving, think on your feet, never have the same day type of job that attracts us to being a physican in the first place. This is why the extra years of BS are worthwhile to me.

 

[Haemulon]

This is true. You would not want to throw a new grad PA into a practice and give them full autonomy. However, as a doctor becomes more comfortable with a PA's skills it is not uncommon for them to be very much on their own. I believe in surgery PAs function more as a first assistant but in seeing clinic patients they can be taught (after graduating) how to practice like the doctor.

Within certain boundries, I agree with you. The key here is for a PA to recognise the limits of their training, and not try to handle more than they are capable of. While this statement holds true for physicians as well (ie know when to refer), it is even more significant for PA's because seemingly simple patients can in fact be very complicated and can deteriorate and get out of hand very quickly. And Lets also not forget about the occassional zebra that a physican would be more likely to pick up. One final point: the whole purpose of the PA profession is to ASSIST physicians, not to practice as them. Its even in the PA creed from what I understand, or whatever its called.

 

[Haemulon]

In my (very limited) experience, the midlevels are given the routine stuff to deal with so the doc has more time for the cases that are more challenging (read: interesting). Whenever something ventures beyond routine the midlevels have to go to the doc for advice on what to do, or hand over the case. I'm sure if an individual was particularly capable they would be given more responsiblilty.

For many of us its the complex, problem solving, think on your feet, never have the same day type of job that attracts us to being a physican in the first place. This is why the extra years of BS are worthwhile to me.

Heck yeh. That's a major reason I am so motiveated for this as well.

 

[trainride]

I agree with the fact that PAs typically treat the mundane everyday strep throat etc. in order to free up the physician to take care of more difficult patients. This is why PAs are so valuable and why I would rather become a doctor.

 

[njbmd]

LOL. I was with you on your post until you tried to suggest PA school was harder than med school. It's hard, but certainly not harder.

Med school has really just 20 months of course work (Aug thru May times two), and biochem is not an insignificant course, so it's probably not a huge difference in actual months when you adjust for lack of that course. (Even if you assume that is the only difference, which it is not -- FWIW, some of the PA's I have known while in grad school did not really cover exactly the same material or level of detail as in med school, based on their text books.) But more importantly, a big portion of what makes med school hard is Step 1 looming at the end, and the fact that you are competing in rank with other med students. The real learning in medicine comes after the basic science years, during your rotations and residency, though. Everything before is just foundation.

"Hard versus Easy" is subjective. Certainly there is more material to be covered and mastered in medical school but with disciplined study, large volumes of material can be mastered as most medical students do. For some folks PA school is hard and for some folks, PA school is easy. Ditto for medical school.

Step I does not come at the "end" of medical school but at the end of second year. Most (if not all allopathic medical schools at this point) require that USMLE Step I and II [CK & CS] be passed before graduation and that Step I be passed before allowing to complete third year. You may be able to start third year (not at my school but at others) but if your grade comes in as a fail, you will be pulled out of clinicals.

To answer the OP's Question: Some medical schools will allow exemption from courses taken within the confines of graduate school. I was offered an exemption from both Physio and Biochem since I had taken these courses as part of my Ph.D. and had taught both of these course at the medical school level. (I did not take the exemption because of easy honors). Students entering with Ph.Ds in Anatomy and Neuroscience had similiar offers.

Other than the above, no matter what you did prior to medical school, you go the full four years and take every rotation unless you transfer into a medical school with advanced standing from another LCME certified school.

 

[Law2Doc]

I'm assuming that this was not illegal, since he made it sound like he did that all the time.

Doing it all the time has never been an accepted standard for whether something is illegal. Criminals do their misdeeds all the time too.

 

[Critical Mass]

To answer the OP's Question: Some medical schools will allow exemption from courses taken within the confines of graduate school. I was offered an exemption from both Physio and Biochem since I had taken these courses as part of my Ph.D. and had taught both of these course at the medical school level. (I did not take the exemption because of easy honors). Students entering with Ph.Ds in Anatomy and Neuroscience had similiar offers.

I should have looked into your school. Mine gives no exemptions for anything.

 

[Law2Doc]

Step I does not come at the "end" of medical school but at the end of second year.

If you read the prior discussion the comparison being made, to which my post you quoted was responding, was between the 15 months of PA school and the first two years of med school (the basic science, coursework phase). Step I comes at the "end" of that. Which is what I was attempting to say, if I didn't (although I actually think it was clear from the context).

 

[Haemulon]

Granted, a bunch of med students talking about PA work is probably a little silly, but let me toss in my few cents.

I actually think trainride is probably right. PAs can do anything an MD does, but the big caveat is the "as long as the MD allows it". My understanding is that the PA, like a resident, practices under the license of a physician, meaning that as long as the attending is comfortable with it, they can do it. Their skill sets, unlike ours, are acquired on the job, so actually some specialist PAs may have equivalent skill sets to docs.

As I mentioned a few months ago, I had a PA who was going to operate on my leg, and made no mention of having a surgeon in the room with him. I'm assuming that this was not illegal, since he made it sound like he did that all the time.

Ya know, I would insist on a surgeon. Maybe a PA may be competant enough to handle it, maybe not. But there are some things that I just won't bend one. When I go to see my physician, I want to see my physician and not his representative PA that is helping to lighten his load. When I need an operation, I want my surgeon to be there, not just his assistant running the show. Maybe this is stubborn or inflexible of me. But It is just my own personal feelings. I have had a number of bad experiences with PA's attempting to treat me and flubbing things up because they did not want to bring in the physician when it was appropriate. I am not implying this is the case for all or even most PA's, its just my own experience that has shaped how I want my own care to be managed.

 

[trainride]

I have had a number of bad experiences with PA's attempting to treat me and flubbing things up because they did not want to bring in the physician when it was appropriate. I am not implying this is the case for all or even most PA's, its just my own experience that has shaped how I want my own care to be managed.

You had a bad PA that did not know their role and probably should have went to medical school

 

[Haemulon]

You had a bad PA that did not know their role and probably should have went to medical school

Agreed. Like I said, I am not trying to generalize, it was just my own experience. Once that trust/respect is violated, its never quite the same. Fair or not.

Now on the other hand, I had a very good experience with another PA in minor care emergency for my son. He was very knowledgable and even knew when to get a consult to help confirm his diagnosis. I would certainly trust him in similar circumstances in the future.

 

[Haemulon]

The ironic part is that I would have been okay with it (this was a pretty simple surgery). But as I have said before, the PA never identified himself as a PA (no name badge, the RN told me when I arrived that "the doctor will be in in a minute), and I was under the impression that he was a doctor until I read my discharge paperwork. That was the deal-breaker for me.

Yeh, that is misleading. The patient has a right to be informed about who is treating them and what that persons qualifications are. Ah well, live and learn.

 

[beauregard]

I actually go to a PA for most all of my medical issues. She really is much more capable and intelligent than many of the doctors in my hometown, and I'd trust her diagnostic skills over many physicians I've known as well.

PAs were listed in the top 5 jobs of 05. I can definitely see why they would be too. If I can't get into medical school I will definitely try PA school (not that they are any easier to get into).

But to the OP, I think that PA school would be an insanely expensive step to medical school. I would at least practice as a PA for awhile before you start applying to MD programs.

 

[8744]

PA school has a rough curriculum.

Of course, it goes against the nature of a medical student to admit that something other than medical school may be academically challenging.

You know, I'm always inclined to respect PAs because I know a lot of them and work with them all the time. I also am somewhat critical of medical training and, as a matter of fact the curriculum at the Marine Corps Infantry Squad Leader Course was actually a lot more challenging because there were no "do overs" or second chances and it didn't involve any biochemistry.

But let's not get ridiculous. Not only is the medical school didactic curriculum significantly longer but we also cram a lot more into the time.

Our clinical training is also a lot more intensive than a PAs. I know this is not the conventional wisdom as we carry egalitariansim to ridiculous lengths but dude, I have been on rotations as a medical student with PAs and while I wouldn't say they were treated like second class citizens, they did no call, did not stay late, and did not, on a regular basis work on weekends. If all other things were equal (and they're not) as a fourth year medical student you can expect to have at least twice as much clinical experience and didactics as a PA.

The trouble with the "PA are better than Doctors" crowd is they have the secret to compressing the space-time continuum, cramming everything expected of an MD into less time while still not running around like those poor three-year bastards at Duke.

They have also solved the problem of human nature, as there are, apparently, no PA slackers who might roll their eyes on some rotations and try to scam out of as much as they can.

Please. You can be an intelligent, reasonably motivated nurse or Paramedic and make it into and through PA school with ease but you would have your lunch eaten, your ass handed to you, and your clocks cleaned in medical school.

 

[8744]

And here's a little wisdom:

When you're a first year medical student you are impressed with PAs because you don't know crap and they run around wearing white coats. On the other hand you are pretty much impressed with anybody who seems to know what they're doing.

When you start third year and still don't know crap on a practical level you may be impressed with the skill of the PA students who are rotating with you because at that point, they have six or seven months of clinical experience compared to your none. But you are also impressed with the fourth year medical students who also seem to be at home in the big, threatening hospital.

When you are an intern you may envy the PAs because they have a limited, clearly defined job at which they are proficient while you are shopped around all over the place never really getting traction. And because PAs are valued employees with real contracts and salaries (and not indentured servants like residents) they are treated a lot better than you will be because they can quit and can easily find another job. No PAs ever do call. They may work shifts but this is not, repeat not, the same as call. In fact, most PAs would laugh or demand a huge tribute if they were asked to work back to back 30-hour calls (the infamous Friday-Sunday weekend call).

When you are almost done with your second year of residency, however, while you have learned to respect everyone from the cafeteria lady to your attending, that doesn't mean that the cafeteria lady knows as much as you do and you find yourself thinking that, apart from their clearly defined job, the PAs don't really know that much.

I imagine a third year Medicine resident, at the top of his game and contemplating either a fellowship or a "chief year" would laugh at the idea that some guy whose formal education ended after two and a half years is really just the same as he is.

 

[8744]

I actually go to a PA for most all of my medical issues. She really is much more capable and intelligent than many of the doctors in my hometown, and I'd trust her diagnostic skills over many physicians I've known as well.

PAs were listed in the top 5 jobs of 05. I can definitely see why they would be too. If I can't get into medical school I will definitely try PA school (not that they are any easier to get into).

But to the OP, I think that PA school would be an insanely expensive step to medical school. I would at least practice as a PA for awhile before you start applying to MD programs.

Meaning no offense because I'm assuming you are young and healthy like most pre-meds, but what exactly are the complicated diagnostic challenges you present to the doctors and PAs in your town which could not as easily be handled by a reasonably savvy school nurse?

Whether the PA is more intelligent or capable than the doctors in your town is impossible to know. It may be that she is just more "into" the low-level stuff that bores your Family Practioner to tears and makes him wish he'd matched into radiology.

As for the popularity of the PA field, well, people aren't stupid. You can sweat for seven years and only make a little more than a primary care PA who had an easier and shorter school and no residency.

You know, statistics being what they are, you can compare a random sample of PA students and medical students and while the distribution curves of their IQ (or SAT scores or any other objective measure of intelligence) may overlap a little, the overlap will be at the low end of the medical student curve. You can throw out all of the anecdotal crap you want (and I have certainly done a lot of that) but that's the way it is.

 

[blakemd]

I didn't see anyone actually answer the posters question. If you become a PA, you can sub specialize now, which requires a test similar to physician BC. You complete a one year residency program after a PA program, many hospitals offer PA residencies. Your primary specialty is essentially whatever you have a keen eye for and have experience with, which may be PC, IM, EM etc. Thoracic surgery is the best paying PA specialty and most competitive residency.

I am right with you etjaipleure, I'm leaning towards becoming a PA before a doc. Most people on a pre-med forum are going to naturally be against it though, so I've yet to hear much (really none) positive input on the idea.

 

[blakemd]

I actually go to a PA for most all of my medical issues. She really is much more capable and intelligent than many of the doctors in my hometown, and I'd trust her diagnostic skills over many physicians I've known as well.

PAs were listed in the top 5 jobs of 05. I can definitely see why they would be too. If I can't get into medical school I will definitely try PA school (not that they are any easier to get into).

But to the OP, I think that PA school would be an insanely expensive step to medical school. I would at least practice as a PA for awhile before you start applying to MD programs.

FYI - PA school is insanely cheap.

Totals:

$2,746​

$1,383​

All tuition, fees, licensing etc - everything for $4,219

 

[Beau Geste]

I was wondering...does anyone know if you get a masters of science as a physician assistant in cardiothoracic surgery, if you wanted to go for a doctor of medicine, do you still have to go for the full four years, then do a residency? I was just wondering because a PA would already have clinical experiences and medical experience and I was just wondering if they would make you go the full time in med school. I'm getting my PA soon and I'm not sure whether I want to continue after that, but I was thinking about going in to radiology. I wanted to become a PA so I can get some experience first and then think about whether I wanted to continue to become a doctor.

There are no PA to MD/DO bridging programs in this country (yet).

 

[Beau Geste]

FYI - PA school is insanely cheap.

Totals:

$2,746​

$1,383​

All tuition, fees, licensing etc - everything for $4,219

where did you get these numbers?

 

[8744]

I didn't see anyone actually answer the posters question. If you become a PA, you can sub specialize now, which requires a test similar to physician BC. You complete a one year residency program after a PA program, many hospitals offer PA residencies. Your primary specialty is essentially whatever you have a keen eye for and have experience with, which may be PC, IM, EM etc. Thoracic surgery is the best paying PA specialty and most competitive residency.

I am right with you etjaipleure, I'm leaning towards becoming a PA before a doc. Most people on a pre-med forum are going to naturally be against it though, so I've yet to hear much (really none) positive input on the idea.

Whoa. You will get plenty of positive input on becoming a PA. It is a rational choice that will offer a very good salary for a long but not crazy-long training in an interesting profession where you will be a valuable and much sought-after employee.

But you will not be the equivalent of a Physician in knowledge or skill.

Sorry. You're asking the wrong set of people what they think about PAs.

 

[Beau Geste]

I concur. There is a forum for clinicians, many of which are PAs. You would get a warmer response there.

 

[momtwo]

Sorry. You're asking the wrong set of people what they think about PAs.

Well..I'm neutral. One of my daughter's is a PA (Duke graduate) and my other daughter will be in Med School (class of 2011).....
Both great career choices IMO - but not the same. My PA daughter is practicing in oncology right now and loving it. It was a perfect career choice for her. There are a bunch of great PA forums offering tons of support (i post on them too). But if you want to ask anything special - PM me. Good Luck.

 

[Law2Doc]

There are no PA to MD/DO bridging programs in this country (yet).

I doubt there ever will be. Med schools are sometimes sensitive to the notion of poaching students from other healthcare fields, and few PA programs are going to relish the idea of becoming stepping stones.

 

[core0]

See, what will actually happen is this: You'll go to PA school, you'll get a job, then you'll never go back to med school because you don't want to give up the income. It happens all the time, and probably 3/4 of the PAs I've ever talked to at some point say, "I thought about going to med school, but . . . "
Very few docs finish a residency only to start another one later, and very few professionals (RN, PA, NP) give up the income to pursue medicine.

I would have to agree with this. The time to go would be early in your career. Once you have good income it is hard to give that up for a minimum of seven years to get your MD. I think EMEDPA did a look at this and the opportunity cost was over $1 million. So in the rest of your career you would have to make up that amount over what you made as a PA just to break even. This is for a well paying specialty like EM. If you were looking at IM or FP it would take longer to make up. If you were going from a specialty like CT surg to FP it makes even less sense.

That being said I think the phenomenon of PA's going to med school is increasing. I can personally think of three PA's that have gone to med school recently. Now that is a small percentage (3 of 900 in the state) but it is up from 0. This may be a consequence of the younger age of PA students. Either they have not been around medicine long enough to know that PA school was going to be right for them or they are young enough to go to med school and make it pay off.

I made that decision 8 years ago. I got into PA school and med school at the same time. I was 35 at the time. I have been a PA for six year now. If I went to med school I would have finished a three year residency last year and as a FP physician for example I would be making about what I am making now. Now a physician has an opportunity for partnership and a greater income, but I really don't want to run a business.

I decided early on that mobility and quality of life were important. I work less than the physicians that I work for and dont take call. They make five times my salary and they earn it. The other thing that I appreciate is that the buck stops with them. If I cannot figure something out or am unsure then I get ahold of them and its their decision. On the other hand they don't have that luxury. The other part is that they are very good at their jobs, but that is what they will do for the rest of their careers. I have already made one change and may make others. The thing that I like best about being a PA is the lateral mobility. I went from Peds GI to adult GI. To do that in the MD world would require going back to school for a three year residency and three year fellowship. Probably why you don't see many physicians changing specialties.

David Carpenter, PA-C

 

[core0]

FYI - PA school is insanely cheap.

Totals:

$2,746​

$1,383​

All tuition, fees, licensing etc - everything for $4,219

not sure where you got this but I have $80k of student loans that say otherwise.

David Carpenter, PA-C

 

[SupergreenMnM]

I would have to agree with this. The time to go would be early in your career. Once you have good income it is hard to give that up for a minimum of seven years to get your MD. I think EMEDPA did a look at this and the opportunity cost was over $1 million. So in the rest of your career you would have to make up that amount over what you made as a PA just to break even. This is for a well paying specialty like EM. If you were looking at IM or FP it would take longer to make up. If you were going from a specialty like CT surg to FP it makes even less sense.

That being said I think the phenomenon of PA's going to med school is increasing. I can personally think of three PA's that have gone to med school recently. Now that is a small percentage (3 of 900 in the state) but it is up from 0. This may be a consequence of the younger age of PA students. Either they have not been around medicine long enough to know that PA school was going to be right for them or they are young enough to go to med school and make it pay off.

I made that decision 8 years ago. I got into PA school and med school at the same time. I was 35 at the time. I have been a PA for six year now. If I went to med school I would have finished a three year residency last year and as a FP physician for example I would be making about what I am making now. Now a physician has an opportunity for partnership and a greater income, but I really don't want to run a business.

I decided early on that mobility and quality of life were important. I work less than the physicians that I work for and dont take call. They make five times my salary and they earn it. The other thing that I appreciate is that the buck stops with them. If I cannot figure something out or am unsure then I get ahold of them and its their decision. On the other hand they don't have that luxury. The other part is that they are very good at their jobs, but that is what they will do for the rest of their careers. I have already made one change and may make others. The thing that I like best about being a PA is the lateral mobility. I went from Peds GI to adult GI. To do that in the MD world would require going back to school for a three year residency and three year fellowship. Probably why you don't see many physicians changing specialties.

David Carpenter, PA-C

I will second this well thought out post; I know several PAs and lateral mobility and early entrance to their career are major factors that give them satisfaction in their jobs. If you go into PA school thinking it will lead later to an MD, or that a PA is just about as good as an MD, you will disappointed. Go into PA school to be a PA if that is what you want, it has many things that make it an attractive career in and of itself.

 

[momtwo]

I will second this well thought out post; I know several PAs and lateral mobility and early entrance to their career are major factors that give them satisfaction in their jobs. If you go into PA school thinking it will lead later to an MD, or that a PA is just about as good as an MD, you will disappointed. Go into PA school to be a PA if that is what you want, it has many things that make it an attractive career in and of itself.

Agreeing! My daughter is 24 and practicing as a PA. Doing exactly what she wanted, good earnings, great hours. She considered MD (in fact during her whole undergrad period she was undecided til application time came). MD, she finally figured out, wasn't what she wanted.

Someone said the PA schools are not keen to those using PA as a stepping stone. Duke was VERY much that way in their acceptance process. The Duke PA class was very small (45-50) and close-knit - they all had their hearts set on PA not MD - otherwise why wouldn't they have gone straight to medical school? The undergrad preparation for my PA daughter and my (future) MD daughter was basically the same (high GPA, huge EC's, EMS, volunteer, same courses - just different test MCAT vs. GRE) but their ideas of what they wanted later from life/career were different. Generally speaking each of them went for what they thought would give them the futures they wanted. Each one of them could easily have chosen the other career path and gotten in to a program but neither would have been happy with the other choice. My MD daughter for instance could have applied to a PA program this application cycle as a "back up" but knew that was totally out of the question. She'd have kept trying for MD if it didn't work out first shot.

 

[AnEyeLikeMars]

I didn't see anyone actually answer the posters question. If you become a PA, you can sub specialize now, which requires a test similar to physician BC. You complete a one year residency program after a PA program, many hospitals offer PA residencies. Your primary specialty is essentially whatever you have a keen eye for and have experience with, which may be PC, IM, EM etc. Thoracic surgery is the best paying PA specialty and most competitive residency.

I am right with you etjaipleure, I'm leaning towards becoming a PA before a doc. Most people on a pre-med forum are going to naturally be against it though, so I've yet to hear much (really none) positive input on the idea.

I understand if someone becomes a PA and then realizes they want to become an MD, but to me it makes no sense at all to plan to become a PA then go to medical school. Why on Earth would anyone want to do this? I'm not devaluing PA as a career option, it's actually a great health-care field with good income, lifestyle potential, and opportunities for meaningful clinical care. But it's a different job. If you want to be a doctor, go to med school.

 

[Law2Doc]

Think of it as the ultimate EC and clinical experience all rolled in to one. My PA degree trumps your 40hrs shadowing an FP.

Welcome to the New America.

It's only a matter of time until you have to be a practicing physician to get into med school.

 

[Critical Mass]

I would have to agree with this. The time to go would be early in your career. Once you have good income it is hard to give that up for a minimum of seven years to get your MD. I think EMEDPA did a look at this and the opportunity cost was over $1 million.

emedpa should stop by if this discussion continues. The cost in tuition/fees for MD vs. PA is something like PA = MD/4 at my campus.

If you are a PA making 80K a year, 8 years of lost salary in med school/residency would be 640K. Add 40K (living plus tuition at a reasonable state school) X 4 years of debt for med school, and that comes to 800K. Of course if you have a working spouse you won't have to borrow that much. A private school would cost more. I also know PA's who make more than that, so you're going to have a wide confidence interval on the total cost. emed is pretty much on track regarding this sort of thing.

I think that in this thread, the OP was actually just a little bit misinformed about what a PA is/does. PA schools often spend a lot of time in the interview asking you how much you know about MD vs. PA and/or how much time you've spent with actual PA's. They want to concentrate their time/money on those who are committed to the PA profession.

Premedical education is already too time-intensive to tack on another 2-3 years IMO.

 

[deleted6669]

emedpa should stop by if this discussion continues. The cost in tuition/fees for MD vs. PA is something like PA = MD/4 at my campus.

If you are a PA making 80K a year, 8 years of lost salary in med school/residency would be 640K. Add 40K (living plus tuition at a reasonable state school) X 4 years of debt for med school, and that comes to 800K. Of course if you have a working spouse you won't have to borrow that much. A private school would cost more. I also know PA's who make more than that, so you're going to have a wide confidence interval on the total cost. emed is pretty much on track regarding this sort of thing.

I think that in this thread, the OP was actually just a little bit misinformed about what a PA is/does. PA schools often spend a lot of time in the interview asking you how much you know about MD vs. PA and/or how much time you've spent with actual PA's. They want to concentrate their time/money on those who are committed to the PA profession.

Premedical education is already too time-intensive to tack on another 2-3 years IMO.

since you asked....my cost to attend medschool:
price of medschool school 100k ish
lost income for 7 yrs @ 140k/yr= 980k
income as a resident + 45k/yr x 3 yrs=135k
that's 945k not including other loans I would need to take out to continue to pay my mortgage for 4 yrs, feed my kids, put gas in the car, etc that would probably be another 100k as well so well over 1 million dollars......now assume I could double my salary as an em attending to 280k which is quite doable, it will still take me quite a while to break even.....around the time most folks retire actually.....I have also looked into doing this with a full ride nhsc scholarship and doing fp....but guess what, I end up losing money over the course of the career because I would never make up what I lost because fp docs make around what I make now......so 7 yrs of my life and 1 million out the door to make the same money I make now.....no......
now a bridge program.........

 

[Beau Geste]

Keep in mind that not everyone does it for the money. While it's a perk, it's not everything.

I made close to 100K this past year as a speech-therapist and will break 100K this year (hopefully). But, I have been increasingly dissatisfied with my job and want more that even a PhD cannot give (I know - I went through almost 3 years of a PhD program). Medicine is the void that needs to be filled and the physician route is what's best for me. And that's worth a lot finding that out right there.

I also plan to try to expand my business to make extra income while I'm in med school (well, hopefully I get in this year!) to pay off loans and not really "lose" my salary. That's definitely different than most students though.

I personally feel there is a niche for PAs but physicians are not replaceable. Please let's not turn this discussion into "us" vs. "them". People have callings for both fields but one is not "evil" for choosing to be a physician and then fighting for their job.

 

[deleted6669]

I agree that money isn't everything but it would be difficult to give up so much time, miss out on things with the kids, not be able to afford things I can now, etc if I wasn't going to make more and have a better lifestyle after additional training. I could conceiveably become a rural fp doc with huge responsibility doing c-sections and following my own inpts, etc and make 20k/yr less than I make now and spend 1 million dollars to do so.....not acceptable.....now if education were free and someone would pay all my bills while in school I would go tomorrrow for the added job satisfaction but no one has offered to foot that 1 million dollar bill for me yet......
pa's who go back to medschool( like pacmatt and bandit here at sdn) frequently work while in medschool as a pa, some as many as 20-30 hrs/week, but that is even more time away from the family......I think matt worked almost full time yr 1 and 2 and then just a bit yr 3 and 4 and graduated 2nd or 3rd in his class with stratospheric board scores. bandit is an ms3 now and is cutting back on work but has been doing 20-30 hrs/week for ms1 and ms2.