The practical side of a midlevel career

[BruceBanner]

Hello all-

I’ve been a member of this board for a couple years, and I'm at a bit of a personal crossroads.

A little background—I went to college at 23 after working for a few years with the objective of becoming a PA. I graduated with honors in pre-med, have good grades and a lot of varied EC experiences. I volunteered, did some sports, shadowed, lab work, research, tutored, etc…I now work as a senior research asst at Mass General. I will have several first author pubs by next year; one is coming soon. I’ll also have 2-3 second author pubs. I took my MCAT twice, did horrible the first time, and a little better the second time (26Q). I applied MD/DO late last year, got waitlisted at a DO program, and did not get in. Now I am in the midst of my second app cycle, this time all DO. I have one interview so far in Sept. I will be 28 in November. I chose not to take my MCAT a third time for practical/financial reasons---personal choice.

So the point of my post is that I am in a massive state of personal indecision regarding going DO or PA/AA. I know the decision is ultimately mine, and I want to take full and complete responsibility for whatever choice I make. BUT---I am having major reservations about the financial and practical sacrifices of med school. I know I’m not too old, but I’m no spring chicken either to be starting med school. My primary objectives are to have an intellectually stimulating career (at least most of the time), do some direct good for others, and make enough money so I can pursue other interests and build wealth for retirement. I know neither option is going to make me “rich”, but they both offer a comfortable lifestyle (at present, anyways). The debt of med school will be tremendous. I am not a URM or underprivileged special boy so I will have to rely entirely on loans. I already have significant undergrad debt, and I am much more concerned about debt than the average med student. I think a lot of people go into it with this naive attitude of "oh I'll be able to pay off my loans in a couple years anyway, I'll be making 400K!!!"

So I would like to hear from others who may be in the same boat, or from folks who may have some direct insight into this problem. I am sure this is a common point of deliberation for many non-trads. I think I would enjoy being a physician and be good at it, but my fear is that I will be unhappy with the duration of training and delayed financial gratification. I’ve spoke with a number of physicians and their opinions are a mixed bag. Some think being a midlevel is a no-brainer with the state of healthcare and the practical advantages, others say going thru med school is long and tough but the only way to go. Additionally, I read the forums here and there seems to be a lot of bitter/unhappy PA’s. It’s like they have an inferiority complex that can only be cured by getting an MD. Sorry if this is a redundant topic; but I find that no matter what is posted on SDN someone gets annoyed, so what the hell.

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[BartenderDoc]

I am in a similar position as you. I go between wanting to do PA and wanting to do MD/DO on almost a daily basis.. Ive decided that I am going to do the absolute best I can on my MCAT apply early and if I get in then I get in. If I dont then I will apply PA. I am 32 years old, so the time/money thing scares the hell out of me too, but I figure that if I do get into Med school that there is absolutely no way I am turning down that opportunity of a lifetime. I figure over time finances will work themselves out.. If I dont get in, then it wasnt meant to be and ill apply PA.. I think I would be happy doing both, but you have to admit that being a Doc is first choice for most... So good luck with your decision and with everything.

 

[reper89]

i'm with you both. i think the only difference for me is that i'm also looking at the carribbean as an alternative as well. there's a pa school here where i live and a mid-sized university. i was thinking of retaking classes i bombed back in the day and doing sort of a mass application to pa/med schools. i agree it is a daily mind game....

 

[sylvanthus]

I was in the same situation last year. So, I applied to PA programs and DO programs and figured I would make a decision after receiving whatever acceptances I would get. The hard part came when I got into a good PA school and a DO program back home.

I ended up deciding that if I was a PA, I eventually would become frustrated at the need for supervision and not knowing as much as many physicians.

The whole income versus debt thing also was a bit frightening. But, there are many options to pay off student loans if a person goes into a primary care specialty. If a person does something non-primary care like emergency medicine, there are even options to work for a week of 24 hour shifts in the midwest and take the rest of the month off and make 160k.

I think loan repayment is totally doable, we would just have to live like a resident for a few years and get that debt down, moonlight in an urgent care, loan repayments, military, etcetc.

 

[Nasrudin]

You're right to wonder. And I wonder if you aint right. The past recedes into the distance once you move forward. And pretty soon. You just keep going, because you cannot see any other way to go.

I'm 35. In the silly position of wagering all my cash as we speak on outside chance. I don't even know what being practical means anymore.

All I can say is. Forget Social Security and such. For us it's work till you drop then straight to dog food factory.

So given that. Might as well make the run you want out of it. But practically speaking nothing about this thing makes any sense that I can see.

 

[lapelirroja]

Please consider that debt from PA school often rivals that of medical schools. Of course you begin making real money sooner (no residency...unless you want to) but in many cases (most Master's Programs) you will need 100k+ to complete a PA program.

 

[2008orbust]

Hi there. I am a nurse practitioner and loved it for many years. I was not disgruntled at all. In Michigan here, NPs have a lot of autonomy and do not have someone looking over their shoulder. I loved it and after checking around I found out how VERY well compensated I was for our area. I also had SIX weeks paid vacation and took very little call.

I was totally happy, but...

but my work exposed me to some things that ignited a passion that I could only pursue with a medical degree. So off I went.

I can honestly say that if my medical school had not let me in, I would still be happy working as an NP.

I hope that helps some.
Good luck to you, James.

 

[DrJosephKim]

I know many PAs who are very happy. I also know NPs who are now going for the DNP (doctor of nursing practice). I think you have to evaluate your ultimate career goals and look at the work/life balance to consider your priorities.

 

[BruceBanner]

Thanks for the replies all, I appreciate it.

I think my gut is telling me I'll be happier with the PA route. I'm still going to go to my med school interviews, however; as I think it would be sort of foolish not to go and bank on a 'possible' acceptance to a PA program.