RN Considering PA vs MD

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cnarnmd

cnarnmd

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Hello!

I've been browsing this site for awhile now, but this is my first post. I've read many, many opinions on the PA vs MD debate, but wanted to get some opinions on my situation. I'm 23 years old, have a BSN, and have been working as a nurse for 2 years. I am at the point in my career where I want to continue my education, which logically should be NP/CRNA, but I want to practice medicine and I'm not too interested in anesthesia. Unfortunately nursing hasn't been academically challenging or as scientifically focused as I thought it would be. I have a 4.0 and have taken some extra science classes that weren't required for nursing.

I originally wanted to be an MD, but my family thought that as a young female, it would disrupt having a family. For med school, I would still need a year of O Chem, a year of Physics, Biochem, and the MCAT. It would take about two years to get the that done while still working as a nurse. I've looked into some post-bacc programs but they are super expensive. I would probably start med school when I'm 26, MD at 30, and finish residency at 34-35. With a fellowship, I'd most likely be 36. It's a huge time and financial investment, although I currently have no debt and have a good amount of savings.

This leads me to being a PA. I like that PAs are able to change specialties if they want throughout their career (I have certainly done this as a nurse), more flexible schedule, and fewer loans. I only need to take O Chem and the GRE before I would apply. I would still get a good education, but it wouldn't be med school + residency quality. By 26-27, I could be working as a PA in a great specialty making a good salary. But I wonder if after a few years, will I want the higher level of autonomy and knowledge and end up going to medical school? I'm afraid that will always regret not going for it!!

Thanks for reading, and if you have any advice/tips I would appreciate it!
 
PA’s actually have an exhorbant amount of autonomy, especially in the Northeast. Unless you want to specialize in a surgical specialty (because you definitely won’t have a lot of autonomy there), I’d say go the PA route.

Ironically though, I’m in a similar situation, and i didn’t choose PA over MD: 22 y/o EMT, no debt, looking to advance knowledge in the medical field with excellent autonomy, hoping to start a family before said eggs run out, etc. Ultimately, i found that my decision stemmed from my short-term goals: to go to medical school, nail STEP, match uro—as oppose to my long-term goals: to provide for immediate family and produce a couple of kids. In the end, you’ll have to decide which set of goals are more important to you/non-negotiable. For me, it was the former set of goals...hence my decision to go MD. I’d recommend for you to create a similar set of lists. Hope this’ll help with your decision somewhat!
 
MedicineN'Jazz said:
PA’s actually have an exhorbant amount of autonomy, especially in the Northeast. Unless you want to specialize in a surgical specialty (because you definitely won’t have a lot of autonomy there), I’d say go the PA route.

Ironically though, I’m in a similar situation, and i didn’t choose PA over MD: 22 y/o EMT, no debt, looking to advance knowledge in the medical field with excellent autonomy, hoping to start a family before said eggs run out, etc. Ultimately, i found that my decision stemmed from my short-term goals: to go to medical school, nail STEP, match uro—as oppose to my long-term goals: to provide for immediate family and produce a couple of kids. In the end, you’ll have to decide which set of goals are more important to you/non-negotiable. For me, it was the former set of goals...hence my decision to go MD. I’d recommend for you to create a similar set of lists. Hope this’ll help with your decision somewhat!
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Hi MedicineN'Jazz! Thanks for replying! Interesting how we're in similar situations. How far away from starting med school are you?

The problem is, I would like to specialize in surgery, or at least a procedure based specialty, which is why I am concerned about autonomy as a PA. I mean, making $100K as a PA first assist isn't bad at all, but I know I'd want to do more than just hold retractors and close at the end of a case. I've seen PAs who get to do a lot more in surgery, but they've been working with the same surgeon for 10+ years. I'll definitely make a list of pros/cons and my short and long term goals. Thanks!
 
cnarnmd said:
Hi MedicineN'Jazz! Thanks for replying! Interesting how we're in similar situations. How far away from starting med school are you?

The problem is, I would like to specialize in surgery, or at least a procedure based specialty, which is why I am concerned about autonomy as a PA. I mean, making $100K as a PA first assist isn't bad at all, but I know I'd want to do more than just hold retractors and close at the end of a case. I've seen PAs who get to do a lot more in surgery, but they've been working with the same surgeon for 10+ years. I'll definitely make a list of pros/cons and my short and long term goals. Thanks!
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Im from NY and moving 12.5 hours to go to Michigan. So...I definitely won’t be close lol. It sounds like you had similar concerns to me though. I say fuk it and YOLO. You’re young, you only live once, and it’s only 2 extra years (although I feel as if you can squeeze it into one). Have you thought about taking Orgo 1, Physics 1, Biochemistry for one semester...and then taking Kaplan to supplement the rest? That way, you’ll get a great test prep, content review, will be able to apply, possibly get in, and then finish up pre-reqs the summer before medical school.

Just a thought :/ I doubt this has actually been done
 
MedicineN'Jazz said:
Im from NY and moving 12.5 hours to go to Michigan. So...I definitely won’t be close lol. It sounds like you had similar concerns to me though. I say fuk it and YOLO. You’re young, you only live once, and it’s only 2 extra years (although I feel as if you can squeeze it into one). Have you thought about taking Orgo 1, Physics 1, Biochemistry for one semester...and then taking Kaplan to supplement the rest? That way, you’ll get a great test prep, content review, will be able to apply, possibly get in, and then finish up pre-reqs the summer before medical school.

Just a thought :/ I doubt this has actually been done
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That is a good thought but aren't Orgo 1 and 2 prerequisites for Biochem? I'm also working as a nurse, and want to do well in the classes and on MCAT. I was thinking Fall 2018 - Orgo 1, Spring 2019 - Physics 1 and Orgo 2 (will be rough!), Summer 2019 Biochem and take MCAT, apply in August 2019? Take Physics 2 Fall 2019, start med school in 2020? Not sure if that is realistic at all!
 
cnarnmd said:
That is a good thought but aren't Orgo 1 and 2 prerequisites for Biochem? I'm also working as a nurse, and want to do well in the classes and on MCAT. I was thinking Fall 2018 - Orgo 1, Spring 2019 - Physics 1 and Orgo 2 (will be rough!), Summer 2019 Biochem and take MCAT, apply in August 2019? Take Physics 2 Fall 2019, start med school in 2020? Not sure if that is realistic at all!
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Lol probably not, since you’re working on the side. But for my undergrad atleast, only Orgo 1 was a pre-requisite for Biochemistry.

Either way, do what you feel is best! My ultimste take-home is: apply MD/DO. Don’t focus too much on the gap years. It would suck if you pursued PA...only to regret that decision for the rest of your life
 
Best advice is to take the pre-reqs and time in school off your pros/cons list.
The time will pass either way and you will start a family whenever you are ready.
Yes you can have a family and be a student if you are dedicated and manage your time well.
 
cnarnmd said:
That is a good thought but aren't Orgo 1 and 2 prerequisites for Biochem? I'm also working as a nurse, and want to do well in the classes and on MCAT. I was thinking Fall 2018 - Orgo 1, Spring 2019 - Physics 1 and Orgo 2 (will be rough!), Summer 2019 Biochem and take MCAT, apply in August 2019? Take Physics 2 Fall 2019, start med school in 2020? Not sure if that is realistic at all!
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that is realistic
 
cnarnmd said:
Hello!

I've been browsing this site for awhile now, but this is my first post. I've read many, many opinions on the PA vs MD debate, but wanted to get some opinions on my situation. I'm 23 years old, have a BSN, and have been working as a nurse for 2 years. I am at the point in my career where I want to continue my education, which logically should be NP/CRNA, but I want to practice medicine and I'm not too interested in anesthesia. Unfortunately nursing hasn't been academically challenging or as scientifically focused as I thought it would be. I have a 4.0 and have taken some extra science classes that weren't required for nursing.

I originally wanted to be an MD, but my family thought that as a young female, it would disrupt having a family. For med school, I would still need a year of O Chem, a year of Physics, Biochem, and the MCAT. It would take about two years to get the that done while still working as a nurse. I've looked into some post-bacc programs but they are super expensive. I would probably start med school when I'm 26, MD at 30, and finish residency at 34-35. With a fellowship, I'd most likely be 36. It's a huge time and financial investment, although I currently have no debt and have a good amount of savings.

This leads me to being a PA. I like that PAs are able to change specialties if they want throughout their career (I have certainly done this as a nurse), more flexible schedule, and fewer loans. I only need to take O Chem and the GRE before I would apply. I would still get a good education, but it wouldn't be med school + residency quality. By 26-27, I could be working as a PA in a great specialty making a good salary. But I wonder if after a few years, will I want the higher level of autonomy and knowledge and end up going to medical school? I'm afraid that will always regret not going for it!!

Thanks for reading, and if you have any advice/tips I would appreciate it!
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My sister was in the same position a few years ago, she was 23 and had been working as an RN for a few years, and wanted to make the career shift.. ended up going the PA route... I don't think the shift from RN to MD is well suited for a female who wants to eventually have a family at a reasonable age. There are several pre-reqs you need to take, and then you have to study for the MCAT, whereas with PA, you already have tons of clinical experience and there are less pre-reqs you need to take. Still competitive, but you should be able to get in if all your boxes are checked and numbers are solid... the PAs I have worked with all have very high levels of autonomy and most of the patients honestly assume they are just doctors because in a lot of areas, they do the same thing. I know at our ED (and a lot of other EDs in NYC), a lot of patients come in and are seen by a PA and leave without being seen by a physician...in terms of knowledge, I don't think the difference is enormous (highly variable based on speciality, obviously if you're comparing an ED PA to a dermatologist or someone in NS, the difference in knowledge will be huge for that niche) ... at some med schools, your first and second year class has PA students in it (they have lower passing scores), so the foundation is almost the same... if your main concerns are autonomy and knowledge base, I would go the PA route for sure... just makes more sense for someone coming from nursing that wants to start a family.
 
trobinsonmd said:
My sister was in the same position a few years ago, she was 23 and had been working as an RN for a few years, and wanted to make the career shift.. ended up going the PA route... I don't think the shift from RN to MD is well suited for a female who wants to eventually have a family at a reasonable age. There are several pre-reqs you need to take, and then you have to study for the MCAT, whereas with PA, you already have tons of clinical experience and there are less pre-reqs you need to take. Still competitive, but you should be able to get in if all your boxes are checked and numbers are solid... the PAs I have worked with all have very high levels of autonomy and most of the patients honestly assume they are just doctors because in a lot of areas, they do the same thing. I know at our ED (and a lot of other EDs in NYC), a lot of patients come in and are seen by a PA and leave without being seen by a physician...in terms of knowledge, I don't think the difference is enormous (highly variable based on speciality, obviously if you're comparing an ED PA to a dermatologist or someone in NS, the difference in knowledge will be huge for that niche) ... at some med schools, your first and second year class has PA students in it (they have lower passing scores), so the foundation is almost the same... if your main concerns are autonomy and knowledge base, I would go the PA route for sure... just makes more sense for someone coming from nursing that wants to start a family.
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I agree with this post. But would you still recommend PA to her, knowing that she wants to pursue a surgical subspecialty (where autonomy is unlikely)? I get PA being more family friendly than MD, but if you put in the work, the latter is possible!
 
MedicineN'Jazz said:
I agree with this post. But would you still recommend PA to her, knowing that she wants to pursue a surgical subspecialty (where autonomy is unlikely)? I get PA being more family friendly than MD, but if you put in the work, the latter is possible!
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Honestly, I think it really depends on how sure she is on pursuing a surgical subspecialty and what field she wants to go into. If you are 110% sure that you have to enter a purely surgical field and you value autonomy, I don't think you will be happy as a PA, because they almost never (99.9%) get autonomy in the OR. On the flip end, you're going to be 36 when you start as a surgeon (if all goes well)... I think it also depends on your relationships. If your family is local to where you do your training, and your SO is able to support you and the family while you are doing your training, I would recommend the MD route. I think there a few fields (not sure if you are open to these) where PAs have more autonomy than others... In interventional radiology, I know PAs handle a lot of the less involved cases without an MD and I've heard of PAs doing up to 15 cases a day at some centers...I am in derm, and I know with mohs procedures, most of the time a PA will handle the closure...
 
trobinsonmd said:
Honestly, I think it really depends on how sure she is on pursuing a surgical subspecialty and what field she wants to go into. If you are 110% sure that you have to enter a purely surgical field and you value autonomy, I don't think you will be happy as a PA, because they almost never (99.9%) get autonomy in the OR. On the flip end, you're going to be 36 when you start as a surgeon (if all goes well)... I think it also depends on your relationships. If your family is local to where you do your training, and your SO is able to support you and the family while you are doing your training, I would recommend the MD route. I think there a few fields (not sure if you are open to these) where PAs have more autonomy than others... In interventional radiology, I know PAs handle a lot of the less involved cases without an MD and I've heard of PAs doing up to 15 cases a day at some centers...I am in derm, and I know with mohs procedures, most of the time a PA will handle the closure...
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Golden advise right here
 
trobinsonmd said:
My sister was in the same position a few years ago, she was 23 and had been working as an RN for a few years, and wanted to make the career shift.. ended up going the PA route... I don't think the shift from RN to MD is well suited for a female who wants to eventually have a family at a reasonable age. There are several pre-reqs you need to take, and then you have to study for the MCAT, whereas with PA, you already have tons of clinical experience and there are less pre-reqs you need to take. Still competitive, but you should be able to get in if all your boxes are checked and numbers are solid... the PAs I have worked with all have very high levels of autonomy and most of the patients honestly assume they are just doctors because in a lot of areas, they do the same thing. I know at our ED (and a lot of other EDs in NYC), a lot of patients come in and are seen by a PA and leave without being seen by a physician...in terms of knowledge, I don't think the difference is enormous (highly variable based on speciality, obviously if you're comparing an ED PA to a dermatologist or someone in NS, the difference in knowledge will be huge for that niche) ... at some med schools, your first and second year class has PA students in it (they have lower passing scores), so the foundation is almost the same... if your main concerns are autonomy and knowledge base, I would go the PA route for sure... just makes more sense for someone coming from nursing that wants to start a family.
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Let’s not turn this into an MD vs PA thread..
You are comparing 2 years of graduate training versus 8+ years so let’s not make grand assumptions.
 
Lev0phed said:
that is realistic
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It’s a stretch to take Biochem in the summer and then try and rush the MCAT. You should be taking a May/June MCAT and she’s thinking about a August MCAT? That’s considering trying to study for the MCAT while taking Biochem which is not ideal.
 
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This might be me being naive, but why not NP?
 
NP/PA and MD/DO are very similar but also different in ways which likely may matter to you later on in your career.
Really look into the profession and find what is for you.
 
Blanky said:
Let’s not turn this into an MD vs PA thread..
You are comparing 2 years of graduate training versus 8+ years so let’s not make grand assumptions.
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what grand assumption did I make?
 
Blanky said:
Read sentence two before replying to the first.
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Not quite sure what you're talking about, but in reference to your comment about NP and PA being "very similar", that is wrong and I'm not sure where you're getting that from. NP follows the nursing model of care, vs. PA, which is based off of the medical model... NP is way more primary care oriented...you don't see NPs in fluoro suites or in derm performing closures, they are completely and utterly different
 
trobinsonmd said:
Honestly, I think it really depends on how sure she is on pursuing a surgical subspecialty and what field she wants to go into. If you are 110% sure that you have to enter a purely surgical field and you value autonomy, I don't think you will be happy as a PA, because they almost never (99.9%) get autonomy in the OR. On the flip end, you're going to be 36 when you start as a surgeon (if all goes well)... I think it also depends on your relationships. If your family is local to where you do your training, and your SO is able to support you and the family while you are doing your training, I would recommend the MD route. I think there a few fields (not sure if you are open to these) where PAs have more autonomy than others... In interventional radiology, I know PAs handle a lot of the less involved cases without an MD and I've heard of PAs doing up to 15 cases a day at some centers...I am in derm, and I know with mohs procedures, most of the time a PA will handle the closure...
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Thanks everyone! I have a lot to think about. Right now I am single with no kids, and I don't plan to have kids until my 30's so I can see the MD route potentially working. If I did become a PA, I think I would have to find another specialty other than surgery.
 
Blanky said:
It’s a stretch to take Biochem in the summer and then try and rush the MCAT. You should be taking a May/June MCAT and she’s thinking about a August MCAT? That’s considering trying to study for the MCAT while taking Biochem which is not ideal.
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I definitely wouldn't want to rush the MCAT. Ideally, I would start studying for the MCAT now, although I may not understand much because I haven't taken all the classes. That would give me a year to study while taking the pre-reqs. Is there an advantage to taking MCAT in May/June over August? The only thing I can think of is being able to apply earlier to programs.
 
Try talking to the MD's and PA's in the ward you work in. Try to find out the in's and out's of their position; beyond autonomy and case load. What are some things they do you wouldn't think they would do? Do the PA's chart just as much as the doctors? Will the PA's see less-acuity patients? There are PA's out there that feel like they do the same/similar work as the MDs in house but get paid 1/3rd of what they do. Other PA's I know assist in clinic or ED and walk out the door after their 8/10/12 hour shift. They live a great life and feel like they "can have it all in life" while making 6 figures. EDIT: and they haven't even hit 30 years old yet.

Do the MD's feel like they don't see the patient enough? Or do they just do the procedure and then only see them during rounds while on house call and morning rounds? If you're wanting to have a lot more patient interaction pre-, peri- and post-op, then I would lean towards NP or maybe surgical PA. But if autonomy and actually doing the procedure is more important than that, AND you're willing to make the sacrifice to put off having a significant work/life balance; then medical school is the perfect option.

Just my naive, pre-med two cents. Also, what about CRNA isn't attractive to you? Out of pure curiosity.
 
FutureSurgical said:
Try talking to the MD's and PA's in the ward you work in. Try to find out the in's and out's of their position; beyond autonomy and case load. What are some things they do you wouldn't think they would do? Do the PA's chart just as much as the doctors? Will the PA's see less-acuity patients? There are PA's out there that feel like they do the same/similar work as the MDs in house but get paid 1/3rd of what they do. Other PA's I know assist in clinic or ED and walk out the door after their 8/10/12 hour shift. They live a great life and feel like they "can have it all in life" while making 6 figures. EDIT: and they haven't even hit 30 years old yet.

Do the MD's feel like they don't see the patient enough? Or do they just do the procedure and then only see them during rounds while on house call and morning rounds? If you're wanting to have a lot more patient interaction pre-, peri- and post-op, then I would lean towards NP or maybe surgical PA. But if autonomy and actually doing the procedure is more important than that, AND you're willing to make the sacrifice to put off having a significant work/life balance; then medical school is the perfect option.

Just my naive, pre-med two cents. Also, what about CRNA isn't attractive to you? Out of pure curiosity.
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Cause CRNA is trash?
 
cnarnmd said:
I definitely wouldn't want to rush the MCAT. Ideally, I would start studying for the MCAT now, although I may not understand much because I haven't taken all the classes. That would give me a year to study while taking the pre-reqs. Is there an advantage to taking MCAT in May/June over August? The only thing I can think of is being able to apply earlier to programs.
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No advantage besides knowing your score sooner and being able to apply earlier... I took the exam without taking second semester of physics and biochem... not ideal, but super doable. I did well enough to get into 5+ schools, I think if you use the mcat review books you’ll be good, it’s more about knowing how to take the exam and working the passages than purely knowing content... obviously don’t do what I just said if you don’t have to, but know that it is doable if you must do that.
 
FutureSurgical said:
Try talking to the MD's and PA's in the ward you work in. Try to find out the in's and out's of their position; beyond autonomy and case load. What are some things they do you wouldn't think they would do? Do the PA's chart just as much as the doctors? Will the PA's see less-acuity patients? There are PA's out there that feel like they do the same/similar work as the MDs in house but get paid 1/3rd of what they do. Other PA's I know assist in clinic or ED and walk out the door after their 8/10/12 hour shift. They live a great life and feel like they "can have it all in life" while making 6 figures. EDIT: and they haven't even hit 30 years old yet.

Do the MD's feel like they don't see the patient enough? Or do they just do the procedure and then only see them during rounds while on house call and morning rounds? If you're wanting to have a lot more patient interaction pre-, peri- and post-op, then I would lean towards NP or maybe surgical PA. But if autonomy and actually doing the procedure is more important than that, AND you're willing to make the sacrifice to put off having a significant work/life balance; then medical school is the perfect option.

Just my naive, pre-med two cents. Also, what about CRNA isn't attractive to you? Out of pure curiosity.
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Thanks for your input! I currently work in the OR, but I've worked with hospitalist and ED PAs who do basically the same job as the MDs, but with a much better schedule and less pay. Lots of patient interaction isn't super important to me, to be honest. I've had a good amount of it already as a CNA and now RN 😉

If I was more interested in anesthesia, I would go CRNA. It's a great career. That was actually my plan in nursing school but now seeing what they do on a day-to-day basis, I think I would be bored after awhile. The science behind anesthesia is awesome, and I love working with anesthesiologists/CRNAs, but I don't think that's what I want to do. I'm more interested in what's happening on the other side of the drapes. Things may change, working in the OR is great for seeing the different roles and responsibilities. I plan to shadow as well before I make any decisions.
 
Omg tons of misinformation here. There are some nuance differences between NP and PA I will admit.
The argument of nursing model versus medical model for PA vs NP is silly information from people who don’t actually work with these practitioners.
We could argue that MDs treat diseases while DOs treat the entire body, but we all know that the training is similar and the style of practicing medicine is dependent on the person.
 
And the idea of applying late not being a disadvantage is also terrible advice. You can look up app timelines from others who know more than me.
 
CRNAs are not trash omg... this thread is so detailed it’s sad. CRNAs have an important job and so does Anasthesia do more research OP they are both amazing careers.
 
cnarnmd said:
If I was more interested in anesthesia, I would go CRNA. It's a great career. That was actually my plan in nursing school but now seeing what they do on a day-to-day basis, I think I would be bored after awhile.
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May I ask what about the profession seems "boring?" I've only seen a few surgeries but talked to the surgeon or scrub nurse the entire time. The CRNA's I got to talk to/know went into it like you did; get the accelerated BSN, worked in the ICU for a year and applied to schools. They did it mainly for the "fat paycheck" and thought gas was really cool. Not to slam on them as a profession. They are integral to the OR to make sure the patient is safe while under. But it boiled down to the amount of hours they wanted to work (40-50, maybe 60 at most) while being hands-on doing interesting procedures.
 
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FutureSurgical said:
May I ask what about the profession seems "boring?" I've only seen a few surgeries but talked to the surgeon or scrub nurse the entire time. The CRNA's I got to talk to/know went into it like you did; get the accelerated BSN, worked in the ICU for a year and applied to schools. They did it mainly for the "fat paycheck" and though gas was really cool. Not to slam on them as a profession. They are integral to the OR to make sure the patient is safe while under. But it boiled down to the amount of hours they wanted to work (40-50, maybe 60 at most) while being hands-on doing interesting procedures.
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Anesthesia is definitely cool, and I should put more consideration into CRNA as a career and shadow some CRNAs (not just observe them while I'm circulating/scrubbing). I think it would suit my personality/interests well, because it is very intellectual, but some part of me wants to have a career that doesn't involve sitting behind drapes for a majority of the surgery. Anesthesia is often described as hours of boredom with moments of shear terror! This is true because when the patient is crashing, it's all on them to run the code or give a mass transfusion.
 
If you want to be a mid level then go NP. Whoever said PA and NP are different is right that they stem from different models but is wrong in that they are functionally the same thing in practice. There are plenty of NPs in fluoro suits or first assisting in surgery, closing in derm, etc.

Decide whether you want to be a midlevel or a physician.
 
@cnarnmd Honestly, your opening post comes across as a flight risk regardless of anything you decide to settle on. There are very few people that leave medical school with their initial dreams and wishes completely intact. It's natural for most people to not know whether they will be content 1 year, 5 years, or 10 years down the road with the decisions they make. However, I never understood the type of people that only get satisfaction from doing X thing with their life.

The fact that you've identified that you need to shadow just means that it should be something that is done sooner than latter. Scope of practice for PAs varies from state to state by specialty, therefore there are very few people on this site who can offer you advice on what you are looking for in this area.

Edit: Didn't realize you were already a circulating/scrub nurse.
 
FutureSurgical said:
May I ask what about the profession seems "boring?" I've only seen a few surgeries but talked to the surgeon or scrub nurse the entire time. The CRNA's I got to talk to/know went into it like you did; get the accelerated BSN, worked in the ICU for a year and applied to schools. They did it mainly for the "fat paycheck" and thought gas was really cool. Not to slam on them as a profession. They are integral to the OR to make sure the patient is safe while under. But it boiled down to the amount of hours they wanted to work (40-50, maybe 60 at most) while being hands-on doing interesting procedures.
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CRNA seems boring to me, and I say that after observing a few and observing many surgeries. Seems like a good job for people who don't mind sitting, but I like to be on the move and a greater focus.
 
Pina Colada said:
@cnarnmd Honestly, your opening post comes across as a flight risk regardless of anything you decide to settle on. There are very few people that leave medical school with their initial dreams and wishes completely intact. It's natural for most people to not know whether they will be content 1 year, 5 years, or 10 years down the road with the decisions they make. However, I never understood the type of people that only get satisfaction from doing X thing with their life.

The fact that you've identified that you need to shadow just means that it should be something that is done sooner than latter. Scope of practice for PAs varies from state to state by specialty, therefore there are very few people on this site who can offer you advice on what you are looking for in this area.

Edit: Didn't realize you were already a circulating/scrub nurse.
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Being a flight risk is what I'm trying to avoid! I don't want to be one of those people who are unhappy with whatever decision they make and regret it their entire career. Medical school (and PA school) are a huge commitment and not something I take lightly. I'm just considering all the options right now.
 
My friend struggled with this a lot. There are a LOT of great PA vs MD career switcher stories on youtube if you have the time to watch.
 
Try DO, they love students with previous healthcare experience and Nursing would fit nicely.
 
I struggled with this same problem when I was 23-26. I decided to go MD after I realized I still had time for my wife and children whilst working 30 hours a week as a scrub tech and taking 12-15 hours a semester, including summer. Granted, I’m sure I won’t see them as much during residency. Ultimately I want to be captain of the ship, not the first mate.

As far as prereqs go, that’s only 5 classes, and 4 classes that are MCAT material. You can do Ochem and physics 1 together then physics 2 and biochem, save o chem 2 for after bc it’s not on the MCAT, my school you couldn’t take ochem 2 before biochem unless you got a waiver. Which was easy if you made an A in ochem 1. Then take a few FL AAMC practice exams and you should be good.

There’s never a “best” time to start a family, it’s going to be difficult at first no matter what. Pursue whatever will make you the happiest. Lastly, 34 is not too old to be having your first child. My mother was 38 when she had me and my wife was 34 when she had our first.
 
Just commenting on your potential schedule if you decide to go the MD route: Studying for a year is not realistic, you're going to get diminished returns and you'll hit a plateau that will hurt your score in the long run. An August MCAT is too late. You won't get your score back until September which means you won't get secondaries in until September. A June/July MCAT is the latest one you should take, in my opinion, if you're planning to apply that cycle.

As PapaSmurhpy said, I would do Fall - Orgo 1 and Physics 1 (learning this would be effectively studying) Spring - Biochem and Physics 2 (continue to review what you're learning and review stuff you learned last semester) then do a June MCAT which would give you which would give you 4-6 weeks of time after classes end for some intense review and then just straight practice questions / practice exams.
 
I didn't read everyone's post here but I had to make a similar decision and ended up DO. I will be matriculating in a few weeks and I'm 30. I don't regret this decision at all! Family is equally important to me but I do not believe we need to put that aside. Once I dived head first into getting into med school, I have met so many women who started families DURING med school. With the right support system, it's very doable! You don't have to choose family vs med school just because you're a female. It's unconventional, but our generation will push boundaries.

Even if you do not start a family during med school, 36-37 is not too old. My mom, who is an accountant, had my brother at 37.
 
You seem to be concerned about having a family, but then say in another post that you’re single and not planning on kids until you’re in your 30s... so what’s the problem with going MD if you like autonomy? The reality is, PAs, especially in surgery, don’t do jack. They hold retractors, close, maybe get to do something else here and there (if the surgeon trusts them) and that’s about it. They are “assistants,” it’s in their name. Are you okay with being an assistant? If not, then you have to sacrifice something, at least for a while. But if you’re not planning kids until your 30s, then there’s no problem.
I understand this drive at having a family, but someone mentioned a “reasonable” age and eggs running out, lol. These days, that number has risen by quite a bit. “Reasonable” isn’t early 20s anymore—you can safely have children well into your 30s and even 40s.


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I don't have personal experience with this as a pre-med non-nurse but I have had this talk with many of the female doctors I have worked with over the last few years in ER, OB/GYN, and primary care specialties to get their opinion on the whole "having kids/being mom+doctor thing"

I am in a similar boat in that I *hopefully* will be starting med school at 26. Overall, in all of these specialties, the doctors were unanimous in saying that things have changed and it is totally possible to have children in residency and throughout the whole long ride of becoming a Doctor. Specifically in the ER and OB/GYN setting, many of the doctors said that their fellow residents were very supportive throughout their pregnancies and were willing to cover for them when they could. Granted they did say this is probably dependent on the speciality.

Furthermore, with the ER specifically, it is much easier to design your schedule around kids to make sure you still have plenty of time to spend with them while working. For a lot of hospitals, working only 10-15 shifts a month is full-time.

Not sure if this helps, but it was something I found helpful in relation to this topic!
 
Only choose to become a midlevel rather than a physician if you are fine with not being the expert and, 30 years from now, having to take orders, depending on your specialty, from a doctor 20 years younger than you who just finished residency. If you decide to become a midlevel, since you already have your RN, then you should definitely pursue NP over PA. NPs have more autonomy, and are thus in greater demand and get paid a bit more. There is no upside to choosing PA over NP. The MW report I'll link shows that NPs are in greater demand and make more money: https://www.merritthawkins.com/uploadedFiles/Merritt_Hawkins_2018_incentive_review.pdf
 
DubbiDoctor said:
Only choose to become a midlevel rather than a physician if you are fine with not being the expert and, 30 years from now, having to take orders, depending on your specialty, from a doctor 20 years younger than you who just finished residency. If you decide to become a midlevel, since you already have your RN, then you should definitely pursue NP over PA. NPs have more autonomy, and are thus in greater demand and get paid a bit more. There is no upside to choosing PA over NP. The MW report I'll link shows that NPs are in greater demand and make more money: https://www.merritthawkins.com/uploadedFiles/Merritt_Hawkins_2018_incentive_review.pdf
Click to expand...
And not being in charge is why I don't like RN. In fact it's easy for me to make more than most NPs/PAs I know. I don't this year because I'm a full time college student and doing volunteering and shadowing but my first year out with a two year degree I made 110k gross. Taxes are sure a b*tch.
 
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