I have been a PA for 5 years and will be starting the medical school journey this August. A lot of people ask me why the heck I would want to go back to medical school after being comfortably nestled in what Forbes and US News consider one of the top five careers to have these days. There are many articles out there supporting the PA over MD/DO choice but let me give you the other side of the story....(I preface with my PA experience is all in NJ).
1. No matter how long you are in a speciality, how competent you are or how trusted you are....you will never be completely in charge. There will always be a supervising physician above you. This interaction may be slim and you may have some very significant autonomy, but if you change jobs or get a new boss everything can change. (some PAs can own their own practice, but this is very rare).
2. Want to spearhead a program and make some big changes? Great! Now go find a physician who is going to be as passionate as you about your project. It is very very difficult as a PA to independently start something big without physician oversight.
3. Residency training matters. The knowledge and skill you gain in the 4 years of medical school and 3+ years of residency make a huge difference in your clinical knowledge. I apparently am good at my job, but the attendings I work with (mostly graduated residency two years after I had been a PA) are light years ahead of me with clinical/basic science knowledge. If you want that...become a doc.
4. Debt. Half the debt yes...but also about 1/3 the salary.
5. Moving into hospital administration or becoming a leader in your department is very difficulty. There are some places who have PAs in administrative positions, one even has a PA as the CEO of the hospital. But, all of this is few and far between. I acknowledge it exists, but it is exceedingly hard to find.
6. My first job as a PA I was working 60-80 hours a week flip flopping nights and days every 2 weeks. Now I work 1-2 nights a week and 2-3 days per week. There are other jobs with better schedules, but the weird/long hours are out there.
7. I have always wanted to be a doctor. Deciding between medical school and PA school should not really be the decision. I went to PA school because I did poorly in a few classes and didn't have the confidence that I would be accepted to medical school. If being a doc is your dream....go after it. If you have always wanted to be a doc becoming a PA will NOT fill that void.
With all of the above I will say I have had a relatively lucrative, happy, adventurous career as a PA. I have been able to be involved as the "first PA" in a number of different specialized areas and I have learned a ton clinically. I am competent and I can do many procedures better than or as good as many residents I work with. I have the respect of the residents and attendings I work with and I respect my role as PA and ask for help when needed. But I look at the residents and think to myself, " I want that." I want the formal education in a speciality and then I want to payoff later in life. So what all of this is getting at is...if you want to be a doctor...go to medical school.
Here are some pros about being a PA so I don't seem like a PA basher:
1. Clinical training in school is excellent.
2. You have major flexibility to determine what specialty you want to do.
3. You don't have to deal with much of the administrative nonsense.
4. You can focus mainly on clinical medicine if that is what you want, whereas many attendings in teaching hospitals have other responsibilities.
5. If you have a good schedule. You may be able to make all of those dance recitals and soccer games. (BUT...you may be the one left closing during surgery while the attending slips off to see the game).
6. Moving to another state is relatively easy. You dont have to start a new practice and build a name for yourself.
7. You have an option to do an abbreviated residency if you so choose.
8. Job satisfaction is overall very high. (about 2% of PAs go back to medical school.)
Hope this helps anyone deciding between the two. Feel free to post more questions.
1. No matter how long you are in a speciality, how competent you are or how trusted you are....you will never be completely in charge. There will always be a supervising physician above you. This interaction may be slim and you may have some very significant autonomy, but if you change jobs or get a new boss everything can change. (some PAs can own their own practice, but this is very rare).
2. Want to spearhead a program and make some big changes? Great! Now go find a physician who is going to be as passionate as you about your project. It is very very difficult as a PA to independently start something big without physician oversight.
3. Residency training matters. The knowledge and skill you gain in the 4 years of medical school and 3+ years of residency make a huge difference in your clinical knowledge. I apparently am good at my job, but the attendings I work with (mostly graduated residency two years after I had been a PA) are light years ahead of me with clinical/basic science knowledge. If you want that...become a doc.
4. Debt. Half the debt yes...but also about 1/3 the salary.
5. Moving into hospital administration or becoming a leader in your department is very difficulty. There are some places who have PAs in administrative positions, one even has a PA as the CEO of the hospital. But, all of this is few and far between. I acknowledge it exists, but it is exceedingly hard to find.
6. My first job as a PA I was working 60-80 hours a week flip flopping nights and days every 2 weeks. Now I work 1-2 nights a week and 2-3 days per week. There are other jobs with better schedules, but the weird/long hours are out there.
7. I have always wanted to be a doctor. Deciding between medical school and PA school should not really be the decision. I went to PA school because I did poorly in a few classes and didn't have the confidence that I would be accepted to medical school. If being a doc is your dream....go after it. If you have always wanted to be a doc becoming a PA will NOT fill that void.
With all of the above I will say I have had a relatively lucrative, happy, adventurous career as a PA. I have been able to be involved as the "first PA" in a number of different specialized areas and I have learned a ton clinically. I am competent and I can do many procedures better than or as good as many residents I work with. I have the respect of the residents and attendings I work with and I respect my role as PA and ask for help when needed. But I look at the residents and think to myself, " I want that." I want the formal education in a speciality and then I want to payoff later in life. So what all of this is getting at is...if you want to be a doctor...go to medical school.
Here are some pros about being a PA so I don't seem like a PA basher:
1. Clinical training in school is excellent.
2. You have major flexibility to determine what specialty you want to do.
3. You don't have to deal with much of the administrative nonsense.
4. You can focus mainly on clinical medicine if that is what you want, whereas many attendings in teaching hospitals have other responsibilities.
5. If you have a good schedule. You may be able to make all of those dance recitals and soccer games. (BUT...you may be the one left closing during surgery while the attending slips off to see the game).
6. Moving to another state is relatively easy. You dont have to start a new practice and build a name for yourself.
7. You have an option to do an abbreviated residency if you so choose.
8. Job satisfaction is overall very high. (about 2% of PAs go back to medical school.)
Hope this helps anyone deciding between the two. Feel free to post more questions.
