Physician's Assistant v. MD/DO

[mich79]

---

Members do not see this ad.

That is one of my major concerns with follow the MD route. After two years of post bacc premed work there is no guarantee that after all that work that i will get into a med school. Ic ant imagine the emotional toll i can and will take on those who apply and get turned down. I know nothing in life is a guarantee, and that it is a super copetitive process, but God damn not getting in any school is slowly becoming one of my greatest fear. I have heard so many people speak of it and so dont want that to be me.

Yikes! Came down with the hammer on me! I was going from what a PA I work with has said. She's in peds/ortho, and she's just graduated.

flyingbridge: There's lots of reasons why docs are against new people coming in. Just like any other profession, people can get tired of it, even frustrated. Some get into a position after many year's hard work and will feel threatened by anyone who comes along. Others have been beaten down by malpractice claims and the legal system. And then a lot of docs see people die day after day and they get tired of the stress.

Some may have less selfish, but more arrogant motives. They may think you're not worthy to be a doc, and so they'll make you think a 'lower' profession is more 'suitable' for someone of your talents. I ran into many of these. I'm going through the end of my 3rd application process and I'm about to start my fourth. Feel free to PM me about the drama.

Interestingly, the MD field is in some ways similar to women in the hard sciences. Many women are discouraging for many of the same reasons I mentioned above.

 

[kelsey001]

I just want to add something that hasn't really been brought up yet,although all the comments have been great. There is not one member of the healthcare community that should be working with complete autonomy, as everyone in the healthcare field should enter feeling compelled to work as a team in the best interest of patients. An MD does obviously have more autonomy than a PA, but still refers patients when he/she gets in over their head. I know many family practice MDs that refer people to specialty PAs, because the PA knows more about a certain area. Obviously, MDs and PAs have different knowledge bases, but it's really about what you want to do, and don't let anyone tell you that being a PA is second-best. I know many, many PAs that could have went to med school, but chose PA school instead. They are both amazing professions!

 

[Critical Mass]

I wanted to be a PA--a quarter of the tuition cost and training, better specialty diversity, good salary with less liability, better lifestyle.

The only problem is that they rejected me, so I went to med school instead. Considering state resident status, statistical odds for med school in my state are better. All that I needed was an MCAT score.

 

[musashi]

This has been a very interesting thread to read. Is it wrong to apply to both MD/DO & PA school during the same application season? Preparing for applying (i.e. prereqs) is near identical. I am applying during the '08 season to matriculate in '09 and am seriously considering applying to every MD/DO & PA school in my state (TX) and then see where the cards fall. Part of me worries that this is not showing commitment to one or the other. I've been shadowing both MD/DO's and PA's and have to say honestly that I'm still on the fence. As I continue taking my pre-reqs maybe I will have an epiphany and know the route I should take. I think by shadowing both I'm getting to see both sides of the fence. In TX some of the PA programs are 2.5 years (give or take a few months) so MD/DO scool is only another 1.5 or so.

 

[Kateb4]

Also, I have a friend that completed MD school and started an EM residnency. He quit after a few months because it was too stressful for him. He went back to PA school and now works as a PA in a derm practice. He chose that route because it was much less stress and responsibility, and he decided that he preferred that lifestyle. So, really it's not about one being better than the other, they are just different. I know that there are some PA's that have independant practices, etc. but in general they do have less responsibility and an easier route to practice.

 

[deleted6669]

This has been a very interesting thread to read. Is it wrong to apply to both MD/DO & PA school during the same application season? Preparing for applying (i.e. prereqs) is near identical. I am applying during the '08 season to matriculate in '09 and am seriously considering applying to every MD/DO & PA school in my state (TX) and then see where the cards fall. Part of me worries that this is not showing commitment to one or the other. I've been shadowing both MD/DO's and PA's and have to say honestly that I'm still on the fence. As I continue taking my pre-reqs maybe I will have an epiphany and know the route I should take. I think by shadowing both I'm getting to see both sides of the fence. In TX some of the PA programs are 2.5 years (give or take a few months) so MD/DO scool is only another 1.5 or so.

most md applicants are not good pa school applicant because they lack direct pt care experience. pa schools want folks who are rn/rt/medics with a degree. yes, there are programs( 15 of 140) that will take folks with minimal experience. I wouldn't go to one....

 

[oldpro]

Also, I have a friend that completed MD school and started an EM residnency. He quit after a few months because it was too stressful for him. He went back to PA school and now works as a PA in a derm practice. He chose that route because it was much less stress and responsibility, and he decided that he preferred that lifestyle. So, really it's not about one being better than the other, they are just different. I know that there are some PA's that have independant practices, etc. but in general they do have less responsibility and an easier route to practice.

Just wanted to point out that by practice and law PA are not licensed to practice Medicine and must have the over sight of a MD or DO in some capacity, always. Having an office is not the same as being Licensed to practice medicine, not to split hairs but there is a difference.

I think this is a poor subject because you should be committed to one or the other IMO, It seems that the person described above found out that the lifestyle and great responsibility was not for them, for others it may be, I'm also an RN and there are plenty of people not happy to be a Doc and are great RN's and happy, I was not I wanted something different, thats it do what makes you happy and all win in the end.

I think what bothers me the most are the people who say MD is better no DO no PA no NP no RN and go on and on about pay and lifestyle I think it depends on who you are, Then there are those who push for the other than Physician specialties to "Take over some of the Physician responsibilities" I say go to medschool if you want that if not just be happy with limitations in the end everyone has them all the other specialties and Physicians in their specialties.

Good Luck to everyone and do what makes you the best!

 

[8744]

Also, I have a friend that completed MD school and started an EM residnency. He quit after a few months because it was too stressful for him. He went back to PA school and now works as a PA in a derm practice. He chose that route because it was much less stress and responsibility, and he decided that he preferred that lifestyle. So, really it's not about one being better than the other, they are just different. I know that there are some PA's that have independant practices, etc. but in general they do have less responsibility and an easier route to practice.

Can I be the first to voice the general consensus that your friend is an idiot? Good Lord. At least PA school must have been a snap.

But I agree with your assessment of the difference between being a physician and a mid-level.

 

[drmadness]

well i want to know how medical students ca get migrated to any uk medical college
and which colleg does accept trasfer students
thnksss😳

 

[oldpro]

well i want to know how medical students ca get migrated to any uk medical college
and which colleg does accept trasfer students
thnksss😳

And this has to do with the topic how?

I see you are new start a new thread but it needs to be in the international forum.............................................

 

[primadonna22274]

I have never ever heard of a graduate MD leaving residency to go to PA school to practice as a PA. That is really odd. Why not just try a different residency? I know, hard to match again, yada yada, but strange.
Plenty of PAs practice for a while and then decide to go on to be a doc and I'll likely be one of them, but I've never known anyone to go the opposite route.
Huh.

Also, I have a friend that completed MD school and started an EM residnency. He quit after a few months because it was too stressful for him. He went back to PA school and now works as a PA in a derm practice. He chose that route because it was much less stress and responsibility, and he decided that he preferred that lifestyle. So, really it's not about one being better than the other, they are just different. I know that there are some PA's that have independant practices, etc. but in general they do have less responsibility and an easier route to practice.

 

[Kateb4]

Just wanted to point out that by practice and law PA are not licensed to practice Medicine and must have the over sight of a MD or DO in some capacity, always. Having an office is not the same as being Licensed to practice medicine, not to split hairs but there is a difference.

I think this is a poor subject because you should be committed to one or the other IMO, It seems that the person described above found out that the lifestyle and great responsibility was not for them, for others it may be, I'm also an RN and there are plenty of people not happy to be a Doc and are great RN's and happy, I was not I wanted something different, thats it do what makes you happy and all win in the end.

I think what bothers me the most are the people who say MD is better no DO no PA no NP no RN and go on and on about pay and lifestyle I think it depends on who you are, Then there are those who push for the other than Physician specialties to "Take over some of the Physician responsibilities" I say go to medschool if you want that if not just be happy with limitations in the end everyone has them all the other specialties and Physicians in their specialties.

Good Luck to everyone and do what makes you the best!

I don't know all of the details as to why he did it, I actually met him after the fact, but he had some health problems, and didn't think that he could deal with the responsibility. He was pressured into med school by his dad who was a MD. Personally, I do agree that this is a poor example of a med student, I was trying to point out that there are many reasons that one may choose PA over MD, and that it truely is a different profession that can be ideal for many people. Plus, this person did not have the financial hardship that most of us will endure to go thru med school, his family was wealthy and he got some type of scholarship. (sad that it was wasted though)

Also, Oldpro... many people before me on this thread had discussed how in some states (mine is not one of them) PA's can hold a private practice, in which they are required only to have intermittant chart reviews by an outside MD/DO. I am also not saying that they have the autonomy, or scope of practice of a physician. I am merely reiterating what was mentioned earlier by people more knowledgable about this topic than I am.

 

[oldpro]

I don't know all of the details as to why he did it, I actually met him after the fact, but he had some health problems, and didn't think that he could deal with the responsibility. He was pressured into med school by his dad who was a MD. Personally, I do agree that this is a poor example of a med student, I was trying to point out that there are many reasons that one may choose PA over MD, and that it truely is a different profession that can be ideal for many people. Plus, this person did not have the financial hardship that most of us will endure to go thru med school, his family was wealthy and he got some type of scholarship. (sad that it was wasted though)

Also, Oldpro... many people before me on this thread had discussed how in some states (mine is not one of them) PA's can hold a private practice, in which they are required only to have intermittant chart reviews by an outside MD/DO. I am also not saying that they have the autonomy, or scope of practice of a physician. I am merely reiterating what was mentioned earlier by people more knowledgable about this topic than I am.

Look no problem, just that Medical school is very intense and a lot of pressure to study everything, then move on to clinicals where you continue to study and learn then to years of residencies that you continue to learn, you really never stop learning, I mean no Disrespect to PA's or NP's but they are not physicians and should not take the place of a Physician, I think the term limited practiced is correct and yes I made it clear they are truly not independent but it appears as such since this "Review" has to take place, in fact a NP I used to work with in Hospice said they were "Independent" and would go and asses patients in Assisted living, well there were quite a few times she had to call her associated MD for consultation, she said it was required at times and really to cover her butt legally. See thats the catch you are always going to have to refer to the MD even though at times a PA or a NP could handle it, in reality there are just too many sue happy people and then there are always complications that a PA or NP are not to handle and an MD must handle.

So I have this pet peeve that PA's and NP's are so independent and have less stress those two things are not compatible, there may be more independent sometimes but not 100% and I know the ones who try to be closer to the 100% stress out more due to the risk they are taking.

If you want to be a Doc then go to medical school, if not then be happy with the limitations.

No offense a lot of this is just my opinions

Oh and I do not think the Doc in the story who went to be a PA is crazy like others, it's what they want as much as I want FP RURAL. I will be happy and I'm sure they are happy, they switched to have that less responsibility I understand and respect that.

 

[momtwo]

I was trying to point out that there are many reasons that one may choose PA over MD, and that it truely is a different profession that can be ideal for many people.

It was interesting watching both of my daughters choose their careers. Both went into undergrads thinking, planning for and working hard toward medical school but of course with limited knowledge of what either career entailed. The first daughter choose Physician Assistant somewhere around Junior year of college. She now is working as a Physician Assistant in Oncology and is extremely happy. My younger daughter will start medical school in the fall. It had nothing to do with ability - the one who went to PA school could definitely have gone to medical school. But rather it had to do with lifestyle choices, long range goals, etc. I think both careers are fabulous and am very glad both of my daughters researched and found out which career suited them better personally. I love the fact that they each understand and respect the other one's decision. Both put a lot of thought into their choices - the second daughter well knows that PA schooling would have meant investing less time but also I think has a realistic view of what she's in for. To prepare for both schools they kept great GPA's, took rigourous undergrad courses, volunteered a lot, were EMT's, held positions in professional clubs on campus and worked many hours in labs too. Once the older one decided PA school she worked 2 years in clinical research during college and did more with EMS. The younger daughter worked more research and was published. Few minor differences in EC's but mostly the same route during undergrads. They worked generally 15-20+ hours a week during college and full time on breaks and summers. They voluteered with EMS heavily...the heavy EC's were valued both by the PA program admissions and the medical school admissions.

 

[oldpro]

You must be really proud of them I hope my 3 choose good fields, the first goes to college sept 2007 if I can get him to apply..........Boys!

 

[momtwo]

You must be really proud of them I hope my 3 choose good fields, the first goes to college sept 2007 if I can get him to apply..........Boys!

Very proud - very exhausted too! I sometimes look at friends with kids that choose simpler paths and dream of what life could have been like around here! These two mowed me over-I hung on for dear life trying to understand(and survive) it all. If I hadn't witnessed it myself I'd not believe what pre-PA and pre-medical school students go through to get accepted to their respective schools. Whatever path our kids choose (and I never would have guessed medicine when mine were small) I do think it's our job to support them and try and understand their choices. Good luck with all the kids - I do hear that boys sometimes need some "encouraging"!

 

[musashi]

So, I am curious as to my original question. Is it wrong or unfocused to apply to both MD/DO & PA school during the same application season and then see where the cards fall?

 

[oldpro]

So, I am curious as to my original question. Is it wrong or unfocused to apply to both MD/DO & PA school during the same application season and then see where the cards fall?

IMO 100% without a DOUBT YES! PA is not a stepping stone to MD or DO and if you really want to be a MD or DO then you will not be happy as a PA.

I think thats pretty clear..................................

 

[primadonna22274]

I don't believe it's wrong, but it might backfire if both programs believe you're flipping a coin, so to speak, and not committed to either one.
You would do yourself a big favor to really contemplate which path is best for you and pursue it.
Good luck...

So, I am curious as to my original question. Is it wrong or unfocused to apply to both MD/DO & PA school during the same application season and then see where the cards fall?

 

[musashi]

Thank you for the replies. The reason I asked about both is would be easy to not get accepted to let's say MD/DOschool and wonder if one could've been accepted at PA or vice versa without having to wait until next year to find out. I don't feel it is a stepping stone. I would be happy either way to be accepted.

 

[deleted6669]

once again, would you realistically get into a pa program? the coursework prereqs are similar but the vast majority of pa programs( 125 of 140) require significant prior medical experience. if you have some, great. if not save your money because most of the other applicants will.
also if you would be happy as either you have not researched both professions adequately. sorry to be harsh but figure out your goal and do that, whichever path it is.

 

[spicedmanna]

once again, would you realistically get into a pa program? the coursework prereqs are similar but the vast majority of pa programs( 125 of 140) require significant prior medical experience. if you have some, great. if not save your money because most of the other applicants will.
also if you would be happy as either you have not researched both professions adequately. sorry to be harsh but figure out your goal and do that, whichever path it is.

I agree with this. OP, I don't think PA schools are necessarily easier to gain acceptance to. The MD and PA paths are ultimately quite different. I second the recommendation to do some more extensive shadowing and research to find out what path you want to take. Then go forward with that chosen path, wholeheartedly.

 

[oldpro]

Yes definitely this is not about what we think is better, just that you should pursue one or the other.

I think PA is great if thats what you really want

If your goal is to be a Doc then really trying to be accepted into a PA program is not the best thing to do, I'm confused why you do not see this? 😕

 

[Faze2]

Also, I have a friend that completed MD school and started an EM residnency. He quit after a few months because it was too stressful for him. He went back to PA school and now works as a PA in a derm practice. He chose that route because it was much less stress and responsibility, and he decided that he preferred that lifestyle. So, really it's not about one being better than the other, they are just different. I know that there are some PA's that have independant practices, etc. but in general they do have less responsibility and an easier route to practice.

Yeah I am still confused about this as well. Did your friend have to complete the full 2.5 years of PA school even though he was an MD? If the answer is yes, in 2.5 years he would have been a lot closer to finishing his residency. Even if he did not need to complete the full 2.5 years, it still seems like a pretty stupid thing to do. To just quit like that after Med school and the boards. Just suck it up and complete your residency. Espcecially because ER docs, after residency, have a pretty good schedule/lifestyle compared to a lot of other docs. I Know their are exceptions to this, but in general most of the attendings where I am work about 3 or 4 days a week tops. Seems pretty stupid to just quit. But I guess it's whatever makes you happy, just seems like a pretty long and expensive route to becoming a PA.

 

[karys]

flyingbridge, I have been a practicing PA in gastroenterology for three years. While the role of a Physician Assistant has always been to assist physicians in patient care, the role of a PA in today's society varies. I myself have decided to apply to med school after three years of practice for reasons that are very specific to me. What you decided to do just depends on your goals and what you want out of a career in health care. PM me if you have any questions.

I have been a PA for over 3 years now and am contemplating going back to medical school. The prospect is overwhelming since I am not 10 years out from undergraduate. I would need to complete 20-30 hours of post bacc prereqs to prepare for MCAT and apply. I am now 31. Thoughts on pursuing a MD degree late in the game? Thoughts on pursuing medical school after PA school? Thanks.

 

[billydoc]

I have been a PA for over 3 years now and am contemplating going back to medical school. The prospect is overwhelming since I am not 10 years out from undergraduate. I would need to complete 20-30 hours of post bacc prereqs to prepare for MCAT and apply. I am now 31. Thoughts on pursuing a MD degree late in the game? Thoughts on pursuing medical school after PA school? Thanks.

You are not really late in the game. Yes, you are a bit older than an average applicant, particularly at allopathic schools, but late by any stretch of immagination. Heck, I'm 37, with quite a few chronic health problems that held me back a while ago. But I'm back in the game. If you really want it, and will not be happy doing anything else, I'd say go for it. I've been an RN for almost 17 years. For the good 8-10 past years I've worked in clinical administration a lot, but also did fee for service and per diem work to keep my skills up to date. I know the future is very uncertain, esp with all this garbage talk of turning U.S health system into another socialist failure. I pretty much gave up very stable six figure income (N.Y job market), with lots of perks. But that's paying the price for what I wanted (or I think I want ).

Good Luck

 

[foreverLaur]

OK this is really old but I found it on a Google search.

I have always wanted to be a doctor for many of the reasons stated above. I recently shadowed an orthopaedic surgeon in the OR because that is why interests me the most. It was her and two other people performing the surgery - all were contributing fairly equally with a bit more work on the MD.

I later found out the other two people were her fourth year resident and an PA. I had no idea that PA's did surgery right next to an MD! Super cool! She spends her OR days bouncing around to different surgeries - the day I was there she did two ortho cases, one CT case, and one gyn surgery. All scrubbed in and actually DOING surgery along with the MD.

On the non OR days, she sees patients for the MD she works for.

From what I saw the PA doing and from what she told me - it sounds pretty awesome!

Any ideas?

 

[deleted6669]

OK this is really old but I found it on a Google search.

I have always wanted to be a doctor for many of the reasons stated above. I recently shadowed an orthopaedic surgeon in the OR because that is why interests me the most. It was her and two other people performing the surgery - all were contributing fairly equally with a bit more work on the MD.

I later found out the other two people were her fourth year resident and an PA. I had no idea that PA's did surgery right next to an MD! Super cool! She spends her OR days bouncing around to different surgeries - the day I was there she did two ortho cases, one CT case, and one gyn surgery. All scrubbed in and actually DOING surgery along with the MD.

On the non OR days, she sees patients for the MD she works for.

From what I saw the PA doing and from what she told me - it sounds pretty awesome!

Any ideas?

see www.physicianassistant.net for a pa specific forum
see www.aapa.org for the pa national site
see www.appap.org for links to optional pa residencies

 

[brookedanielle]

Hello all!!

Currently, I am a pharmacy technician who was pre-med who then switched to pre-dent who then switched to PA who then swtiched to pharmacy after graduating with my BS in Biology. But my thing is PSYCHIATRY. It fascinates me to NO END! I love the mystery of Psychiatric medicine and the treatment of the psych patients. It is a field that lets you get up close and personal with your patients and build good doctor-patient relationships. When I discovered that PA's in psychiatry DID exist, I knew it was for me... I planned to attend PA school after graduation... But this is what nipped it in the bud, so to speak: People talked WAY TOO MUCH CRAP to me about it.... "You're too smart to give up becoming a doctor. You'll be doing the doctor's job but not getting the respect and pay!" So, I realized that I wasn't going to have DOCTOR in front of my name (duh) and I didn't want people just "winding up with me" because the overhead M.D. was booked solid for the next 2 months. The pros to PA, of course, were the 9-5 thing (if in the field of choice) thus giving me a lot of family time... Not that M.D.'s don't have family time, but I'm guessing a PA Mom probably gets a heck of a lot more down time than a practicing MD. Plus it is 2 years of school (well add 1/2 since I need a semester or 2 to get all of my pre-requisites) as opposed to 4 years of grueling med school + 4 years of rotten residency... Then private practice, oh my. One psychiatrist told me that her residency was easier than her private practice on most days. So, I'm still lost... There is no happy ending to my story. I have definitely ruled out Dent (don't want to dig in mouths for the rest of my life) and I have definitely ruled out Pharmacy (BORING! no offense to pharms, but I pretty much hate working in the pharmacy, no room for creativity or problem solving - except successfully running off all the crackheads.) I'm still torn between MD and PA... I HAVE the GPA: 3.8 undergrad, Bio major Chem minor, plus plenty of medical related work experience (haven't weathered through th MCAT yet). But, here I sit, reading post after post filled with opinions (very good ones, too!) and I come to no conclusion! Do MDs seriously not have a life outside of their work? (I'd love to hear from some married, female MDs/residents.) Is PA the right career choice for someone who wants to be a MOTHER of several kids too? I would totally be satisfied with a six figure income, I'd probably be cool with 80K or 90K... Hopefully I won't be the sole breadwinner of my family anyhow. But are psychiatric PAs extremely rare? Or are you seeing more of them? I know I have to make my OWN decision in life, but the more opinions and facts I see, at least I can make an informed one!

 

[foreverLaur]

I think it really depends on the specialty. You can have a family friend lifestyle as an MD but you will give up a lot of income. It is pretty hard to avoid at least a 40 hour work week (not counting paperwork) and the PA/NP profession is no different. I know both PAs and NPs who work in the primary care setting and they are lucky to get out after 40 hours of work a week because there is just so much paperwork nowadays.

It also depends on specialty. The orthopaedic surgeon I shadowed brings her son to work on Saturday when she does paperwork so she can spend some time with him.

After extensive research, talking to as many people as possible in all the professionans, shadowing everyone I could find, and doing some self reflection, I decided upon a Nurse Practitioner. I can make a six digit salary, practice virtually anywhere, work a nice 40 hour workweek, take time off/work part time (doesn't happen with MD/DO), see patients independently, and prescribe meds. I can also become an RNFA and do surgery if I want, which is very appealing. My current plan is to be a dual certified pediatric nurse practitioner (acute care and primary care) so that I have a lot of options. I am getting my undergraduate in psychology and it will take me 3 years to become a nurse practitioner.

My decision to pick NP over PA is that there aren't really any PAs in my area. All the doctors choose to employ nurse practitioners over PAs. You should check that out in your area as well. And I really didn't want to take organic chemistry 🙂

I think you would definitely be happier with being a PA vs an MD/DO in the long run from what you have said. Anyone who tells you that you are inferior has no idea what being an MD is like. You can almost be an MD when you are a PA yet you don't have to go to med school, you don't give up 8+ years of your life to become a doctor, you don't have $200,000 in debt, you aren't massively in debt when you are in your mid 30s and wanting to buy a house and have young kids, you can work part time, you can take time off, and you don't have to deal with the whole malpractice thing and crappy reimbursements! It seems much wiser, especially for a woman/future mother!! Don't let anyone's words discourage you from choosing a non doctor route. You won't be throwing anything away. The doctors my mom works for are lucky to make a 6 digit salary and they were making over $200,000 ten years ago.

I know a lot of unhappy doctors and I haven't met one yet who would encourage someone to go into medicine. I have, however, met a lot of very happy PAs and NPs who definitely encourage people to go that route.

Hello all!!

Currently, I am a pharmacy technician who was pre-med who then switched to pre-dent who then switched to PA who then swtiched to pharmacy after graduating with my BS in Biology. But my thing is PSYCHIATRY. It fascinates me to NO END! I love the mystery of Psychiatric medicine and the treatment of the psych patients. It is a field that lets you get up close and personal with your patients and build good doctor-patient relationships. When I discovered that PA's in psychiatry DID exist, I knew it was for me... I planned to attend PA school after graduation... But this is what nipped it in the bud, so to speak: People talked WAY TOO MUCH CRAP to me about it.... "You're too smart to give up becoming a doctor. You'll be doing the doctor's job but not getting the respect and pay!" So, I realized that I wasn't going to have DOCTOR in front of my name (duh) and I didn't want people just "winding up with me" because the overhead M.D. was booked solid for the next 2 months. The pros to PA, of course, were the 9-5 thing (if in the field of choice) thus giving me a lot of family time... Not that M.D.'s don't have family time, but I'm guessing a PA Mom probably gets a heck of a lot more down time than a practicing MD. Plus it is 2 years of school (well add 1/2 since I need a semester or 2 to get all of my pre-requisites) as opposed to 4 years of grueling med school + 4 years of rotten residency... Then private practice, oh my. One psychiatrist told me that her residency was easier than her private practice on most days. So, I'm still lost... There is no happy ending to my story. I have definitely ruled out Dent (don't want to dig in mouths for the rest of my life) and I have definitely ruled out Pharmacy (BORING! no offense to pharms, but I pretty much hate working in the pharmacy, no room for creativity or problem solving - except successfully running off all the crackheads.) I'm still torn between MD and PA... I HAVE the GPA: 3.8 undergrad, Bio major Chem minor, plus plenty of medical related work experience (haven't weathered through th MCAT yet). But, here I sit, reading post after post filled with opinions (very good ones, too!) and I come to no conclusion! Do MDs seriously not have a life outside of their work? (I'd love to hear from some married, female MDs/residents.) Is PA the right career choice for someone who wants to be a MOTHER of several kids too? I would totally be satisfied with a six figure income, I'd probably be cool with 80K or 90K... Hopefully I won't be the sole breadwinner of my family anyhow. But are psychiatric PAs extremely rare? Or are you seeing more of them? I know I have to make my OWN decision in life, but the more opinions and facts I see, at least I can make an informed one!

 

[primadonna22274]

to brookedanielle: there are psych PAs, but IMO psych is very much an unmined quarry as far as PA utilization goes. There are pockets around the country where there are several. There is more than enough need but not enough people with vision to see how useful a PA would be in psychiatry. There are a couple of psych residencies for PAs, Univ of Iowa is a longstanding and well-respected one. If you check out the AAPA website www.aapa.org there is a link to the PA specialty organizations. I believe there is one for psych PAs but don't know the weblink. Good luck....
I also think that a smart PA with a mental health bent could create a psych job given a willing preceptor/supervising physician (psychiatrist) mentor, even in an area that has not utilized PAs previously. You will see no shortage of PMHNPs (psychiatric mental health nurse practitioner, say that three times fast) wherever you look. Many are excellent mentors as well (at least the one who taught me was awesome).
Good luck,
Lisa PA-C (not in psychiatry but have always done a lot of it in my family practice)

 

[foreverLaur]

primadonna: what made you decide to go to medical school after being a PA?

 

[Kateb4]

Hello all!!

Currently, I am a pharmacy technician who was pre-med who then switched to pre-dent who then switched to PA who then swtiched to pharmacy after graduating with my BS in Biology. But my thing is PSYCHIATRY. It fascinates me to NO END! I love the mystery of Psychiatric medicine and the treatment of the psych patients. It is a field that lets you get up close and personal with your patients and build good doctor-patient relationships. When I discovered that PA's in psychiatry DID exist, I knew it was for me... I planned to attend PA school after graduation... But this is what nipped it in the bud, so to speak: People talked WAY TOO MUCH CRAP to me about it.... "You're too smart to give up becoming a doctor. You'll be doing the doctor's job but not getting the respect and pay!" So, I realized that I wasn't going to have DOCTOR in front of my name (duh) and I didn't want people just "winding up with me" because the overhead M.D. was booked solid for the next 2 months. The pros to PA, of course, were the 9-5 thing (if in the field of choice) thus giving me a lot of family time... Not that M.D.'s don't have family time, but I'm guessing a PA Mom probably gets a heck of a lot more down time than a practicing MD. Plus it is 2 years of school (well add 1/2 since I need a semester or 2 to get all of my pre-requisites) as opposed to 4 years of grueling med school + 4 years of rotten residency... Then private practice, oh my. One psychiatrist told me that her residency was easier than her private practice on most days. So, I'm still lost... There is no happy ending to my story. I have definitely ruled out Dent (don't want to dig in mouths for the rest of my life) and I have definitely ruled out Pharmacy (BORING! no offense to pharms, but I pretty much hate working in the pharmacy, no room for creativity or problem solving - except successfully running off all the crackheads.) I'm still torn between MD and PA... I HAVE the GPA: 3.8 undergrad, Bio major Chem minor, plus plenty of medical related work experience (haven't weathered through th MCAT yet). But, here I sit, reading post after post filled with opinions (very good ones, too!) and I come to no conclusion! Do MDs seriously not have a life outside of their work? (I'd love to hear from some married, female MDs/residents.) Is PA the right career choice for someone who wants to be a MOTHER of several kids too? I would totally be satisfied with a six figure income, I'd probably be cool with 80K or 90K... Hopefully I won't be the sole breadwinner of my family anyhow. But are psychiatric PAs extremely rare? Or are you seeing more of them? I know I have to make my OWN decision in life, but the more opinions and facts I see, at least I can make an informed one!

I am a mother of three and have talked with many docs and residents about family life as a physician. The concensus is that it is definately a priority to many doctors, and you can make it work. My OB's office has three female docs that all work about 30 hours/week and rotate their call. Two of them have small children and are able to spend plenty of time with them, go to school functions, etc. So, I know that it is possible to be a physician and a mom! There are some other specialties that are more flexible for parents as well, and there are some to avoid. You can't however avoid the commitment that is required for med school/residency. It is do-able though. Really, NP or PA are great careers. You just need to evaluate what you want your scope of practice to be, and weigh the benefits and detriments of each option. (So easy to say!) I really think that with the information that you have provided about your goals, that you would be happy in any of those positions.

Anyways, I really wanted to post and say to check out what some moms that are MD/DO have to say at www.mommd.com

 

[Valvool]

In Alaska I lived in a small town called Thorne Bay. There was a clinic there opened three or four days a week and it was run by a PA. He is overseen by a physician, of course, but that physician is usually forty miles away or not on the island at all. The PA functions as a small town doc. Because Alaska lacks healthcare professionals, the ones that do work there are much more autonomous than in the Lower Forty-Eight. Also the lines dividing the different professions are much blurrier. I am in GA now, and the medical environment here is very conservative. Up in Alaska, it's nothing like that. Everyone goes by first names, even with the patients, even the doctors. When a patient comes into the clinic he or she would be hard-pressed to guess who was what in terms of the letters after their name.

 

[deleted6669]

this is very common in alaska. I have several friends who work up there as solo providers. some work 2 weeks on/2 weeks off. some work month on/month off. they all get a full yrs salary for 6 mo work....not a bad gig.

 

[OTD]

Anyone who tells you that you are inferior has no idea what being an MD is like. You can almost be an MD when you are a PA yet you don't have to go to med school, you don't give up 8+ years of your life to become a doctor

Actually this is not accurate. You will never "almost be a doctor" unless you are a 4th year medical student. A NP or PA will never have the knowledge base or skill set of a physician and will need approval of a physician for their treatment plans/orders/scripts.

This is not saying anything bad about either profession. PA's are excellent in their field. But they are not nor never will be doctors (unless they go to medical school of course). They will never be "in charge" because the doctor is the boss, in the end in any dispute the doctor will be the one that wins because of this fact. It's the doctors patient, you are just working for him (much the same way as a resident/attending).

If you want to be an assistant then be a PA, NP then go to NP school.

If you want to be a doctor then go to medical school.

 

[deleted6669]

A NP or PA will never have the knowledge base or skill set of a physician and will need approval of a physician for their treatment plans/orders/scripts.
They will never be "in charge" because the doctor is the boss, in the end in any dispute the doctor will be the one that wins because of this fact. It's the doctors patient, you are just working for him (much the same way as a resident/attending).
.

You are 1/2 right. I don't have the knowledge base of a residency trained /boarded em doc but after years of doing this know more em than the vast majority of non-em physicians. I work solo several times/mo and in that setting I am the one in charge. I run the traumas, the codes, do all procedures, decide who to admit and who gets transfered, etc
I have my own license and DEA #. a physician signs my charts after the fact(often up to 1 month later) but is not involved at all in the decisions that were made. I can consult, of course, but the specialists I consult are not the ones signing the chart.
today I am working another per diem job as "double coverage" at a small rural e.d.
the doc on today has been asleep upstairs throughout my whole shift. I will call him if a code comes in, both other than that it's my show. at my other job I would run the code myself( and have on many occassions).

PS many states now allow pa's to own their own clinics and see all the pts themselves. they need to hire a sponsoring physician to meet whatever the min requirement is for md involvement. in north carolina this involvement is 2 thirt min meetings/yr( q 6 mo) to "discuss the practice" with no chart review requirement.

 

[DNARNAPROTEIN]

I, like many people here, am on the fence of whether to do MD/DO or PA or even possibly something else...like research. Most days I am 100% pro-physician, but then in an instant I could read something or think something and feel like I it is just too much sacrivice. I am a very hard worker and take pride in my academics, but I need a social life too. I think the biggest thing is the unknown...how much do we really have to give up in order to acheive this lofty goal?, is the autonomy really worth the stress?, will I have time to go to a party?.(some of you may think this is not important, but I do(obviously not tonight, since it's 11:30pm on a Sat and I'm on SDN!))

There are many rational reasons to choose PA: less time in school, great salary, decent autonomy. What I keep hearing in my head, however, is a line from the movie A Bronx Tale when the dad says something like "the worst thing in life is wasted talent." I worry that one day if I'm an old, gray PA, I'll start introducing myself as "Hello, I'll be your PA, but I could have gone to medical school." I know there are definitely people who could beat out med school applicants who choose PA instead, but I have to think that being an assistant to someone doing a job you are capable of(ie: be a doctor) could get to a guy after a while.

Like someone else said, most people don't know the diff b/t a PA or NP, but they know a doctor is "better". The thing is that being "better" doesn't neccessarily equal being happier. Ultimately each individual needs to search their soul and find out who they are and who they would like to be, because in the end it's all about being at peace with yourself.

As for this indivdual, I'm going to watch a movie...hmmm, maybe A Bronx Tale is on.

 

[TarHeel55]

There are many rational reasons to choose PA: less time in school, great salary, decent autonomy. What I keep hearing in my head, however, is a line from the movie A Bronx Tale when the dad says something like "the worst thing in life is wasted talent." I worry that one day if I'm an old, gray PA, I'll start introducing myself as "Hello, I'll be your PA, but I could have gone to medical school." I know there are definitely people who could beat out med school applicants who choose PA instead, but I have to think that being an assistant to someone doing a job you are capable of(ie: be a doctor) could get to a guy after a while.

DNA, if I were a PA, I suspect I would feel a bit put out by the implication in your comments above that I had wasted my talent.

I wonder if the feeling you are expressing might be put in a different way. Maybe part of you really wants to dig down deep and understand in nitty gritty detail many of the nuances and subtleties of a particular area of medicine, i.e., maybe part of you wants the understanding and skill set that comes with four years of med school + residency. Maybe you want the opportunity to gain the understanding and skills of a pathologist, or allergist, or reproductive endocrinologist... or any of the other myriad specialties/subspecialties of medicine that require immersing oneself for a number of years post med school and even post residency in the complexities of a relatively narrow slice of medicine.

You could feel very drawn personally to the education and professional life of people with residency training, while still believing that the work that PAs do is challenging and valuable in its own right, and by no means a waste of anyone's talent.

 

[OTD]

You are 1/2 right. I don't have the knowledge base of a residency trained /boarded em doc but after years of doing this know more em than the vast majority of non-em physicians. I work solo several times/mo and in that setting I am the one in charge. I run the traumas, the codes, do all procedures, decide who to admit and who gets transfered, etc
I have my own license and DEA #. a physician signs my charts after the fact(often up to 1 month later) but is not involved at all in the decisions that were made. I can consult, of course, but the specialists I consult are not the ones signing the chart.
today I am working another per diem job as "double coverage" at a small rural e.d.
the doc on today has been asleep upstairs throughout my whole shift. I will call him if a code comes in, both other than that it's my show. at my other job I would run the code myself( and have on many occassions).

PS many states now allow pa's to own their own clinics and see all the pts themselves. they need to hire a sponsoring physician to meet whatever the min requirement is for md involvement. in north carolina this involvement is 2 thirt min meetings/yr( q 6 mo) to "discuss the practice" with no chart review requirement.

I would say you DON'T know more than non EM trained physicians becasue you don't have the background (I was going PA myself at one time, researched it pretty good but that was in the 90'S). Even medicine attendings did residency where they spent many hours in the ED even on surgical problems etc. I work with PA's every day in many different fields, and was trained by a PA that went back to medical school. I respect the field.

Yes I agree you DO know more about EM medicine than non EM JR Residents (the things not in their field like GYN over a 1st year surgery resident), but that's EM medicine only. You know less about definative treatment because you didn't spend the time in medical school to know about Psych even though you aren't going into psychiatry, or to know about the long term treatment for HTN/CHF etc.

I am very impressed with PA's, they are well trained and the surgery PA's I work with have taught me alot about surgery, but I knew more about non surgical medicine as a 4th year med student than those guys/gals with 10 years of surgery PA experience. Treating PID comes to mind, we had a surgical consult that ended up being PID when I was in med school If it had been appendicitis she (the PA) would have been all over it, but since it was PID I knew the diagnosis, she didn't and admitted it as well as admitted she didn't know how to treat it either IF (she wasn't convinced until the OB-GYN agreed with me, after all I was just a 4th year med student).

Yes PA's are awesome in their field but they lack the breadth of knowledge that a doctor possesses.

I will also trust my PA's when it comes to their diagnostic skills IN THEIR FIELD, learned alot from them and they impressed me but if it's outside thier field they struggle more than MD's outside their field due to the nature of the training/job.

 

[DNARNAPROTEIN]

DNA, if I were a PA, I suspect I would feel a bit put out by the implication in your comments above that I had wasted my talent.

I wonder if the feeling you are expressing might be put in a different way. Maybe part of you really wants to dig down deep and understand in nitty gritty detail many of the nuances and subtleties of a particular area of medicine, i.e., maybe part of you wants the understanding and skill set that comes with four years of med school + residency. Maybe you want the opportunity to gain the understanding and skills of a pathologist, or allergist, or reproductive endocrinologist... or any of the other myriad specialties/subspecialties of medicine that require immersing oneself for a number of years post med school and even post residency in the complexities of a relatively narrow slice of medicine.

You could feel very drawn personally to the education and professional life of people with residency training, while still believing that the work that PAs do is challenging and valuable in its own right, and by no means a waste of anyone's talent.

TarHeel - Noted. I believe that a PA does have a challenging job and is extremely valuable in the delivery of healthcare. I just wouldn't want someone capable of amazing things to not realize their full potential and have regrets down the road. Like I said, either career could be the right choice, as long as you have peace with your decision.

 

[primadonna22274]

I'm a PA and I don't feel offended by that thought at all. My first 2 weeks in practice (7 yrs ago) my supervising physician told me I was wasting my talent as a PA and she thought I should get my butt back to med school. Haven't done it yet, for various reasons, primarily financial. As time goes on I don't know if it's worth it. I try to use the talent I have as a PA. I get your drift though, and appreciate your concern for your feelings 🙂

DNA, if I were a PA, I suspect I would feel a bit put out by the implication in your comments above that I had wasted my talent.

.

 

[Krisss17]

I definately regret my time wasted working as an RN. I'm 32 and just starting residency. If I would have gone straight through I would be done by now. Medical school is a very timely endevor if you include the prerecs, medschool and residency. I've found it very challanging and rewarding and look forward to starting my residency but that is alot of time that one could be "living life".

I used to think this way of regretting past actions, but I realize now that if I did not go through the experiences that I had gone through I would have lost out on a lot. I would never have met some of the people that I have met had I chosen to do things at the more "expected" timeline. But at the point I am at now, I'm looking forward to the process and what I will experience each and every step, not just looking at the end goal. To me, the saddest thing is seeing those people who have attained their "goal," but they are so unhappy because they saw what they missed out on instead of all that they experienced.

Burntcrispy, instead of regretting your nursing period, why not think about how it made you more aware of how the health field is really like. Because of your exposure to patient care I'm sure that your clinical reactions in the beginning were a lot more comfortable than those medical students with little to no clinical experience.

 

[spicedmanna]

I used to think this way of regretting past actions, but I realize now that if I did not go through the experiences that I had gone through I would have lost out on a lot. I would never have met some of the people that I have met had I chosen to do things at the more "expected" timeline. But at the point I am at now, I'm looking forward to the process and what I will experience each and every step, not just looking at the end goal. To me, the saddest thing is seeing those people who have attained their "goal," but they are so unhappy because they saw what they missed out on instead of all that they experienced.

Burntcrispy, instead of regretting your nursing period, why not think about how it made you more aware of how the health field is really like. Because of your exposure to patient care I'm sure that your clinical reactions in the beginning were a lot more comfortable than those medical students with little to no clinical experience.

I agree with this. A mentor of mine use to say, "if you could have done it differently, you would have." Whatever we did to get to where we are now, it was necessary and perfect. No regrets...just choices and their results and everything being perfect just the way that it turned out.

 

[MacGyver]

I just want to add something that hasn't really been brought up yet,although all the comments have been great. There is not one member of the healthcare community that should be working with complete autonomy, as everyone in the healthcare field should enter feeling compelled to work as a team in the best interest of patients. An MD does obviously have more autonomy than a PA, but still refers patients when he/she gets in over their head. I know many family practice MDs that refer people to specialty PAs, because the PA knows more about a certain area. Obviously, MDs and PAs have different knowledge bases, but it's really about what you want to do, and don't let anyone tell you that being a PA is second-best. I know many, many PAs that could have went to med school, but chose PA school instead. They are both amazing professions!

Thats BS. MDs dont refer patients to PAs. They refer patients to specialty MDs and the PA who works for that specialty MD sees some of their patients. Huge difference there.

 

[MacGyver]

I know that there are some PA's that have independant practices, etc.

Please name one. I'll give you $50 right now if you can name a PA that has their own practice with no MD oversight/supervision.

 

[foreverLaur]

Please name one. I'll give you $50 right now if you can name a PA that has their own practice with no MD oversight/supervision.

It happens. They are not 100% independent.

From what other members have said,

PAs in Alaska run their own practices and the MD is not often even in the state.

In one of the Carolinas, a nurse practitioner can be independent, but has to discuss the practice two times a year for 30 minutes each time.

 

[Blade28]

It happens. They are not 100% independent.

From what other members have said,

PAs in Alaska run their own practices and the MD is not often even in the state.

In one of the Carolinas, a nurse practitioner can be independent, but has to discuss the practice two times a year for 30 minutes each time.

But often, in these no-physical-supervision settings, doesn't an MD have to at least review/skim/sign charts 1-2 times a month?

 

[foreverLaur]

But often, in these no-physical-supervision settings, doesn't an MD have to at least review/skim/sign charts 1-2 times a month?

Not in all states. From what I heard, in one of the Carolinas it literally is just a discussion over the phone for 30 minutes twice a year.

In the state my aunt lives in, a doctor has to review charts every 4 months, but only a very small percentage and then the doctor just has to sign something saying that they looked okay overall.

 

[Blade28]

Not in all states. From what I heard, in one of the Carolinas it literally is just a discussion over the phone for 30 minutes twice a year.

Wow. That's scary. 😱