Who here regrets med school?

[dadaddadaBATMAN]

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I am mainly wary of my life during and after residency. I need to be able to have a family life and be there for my spouse/kids, something my father has failed to do. I'm risking this balance with MD as marrying the profession is common.

Despite the way some of us may feel, it isn't as though nursing or PA are immune to this attitude. There's just fewer of them that do it. Also, "specializing" as a nurse or PA won't have quite the same meaning as when you're a doc.

Keep that in mind

 

[jakeislove]

je ne regrette rein!

 

[DermViser]

Despite the way some of us may feel, it isn't as though nursing or PA are immune to this attitude. There's just fewer of them that do it. Also, "specializing" as a nurse or PA won't have quite the same meaning as when you're a doc.

Keep that in mind

PAs have less schooling, PERIOD. They also don't have to do residency training to hop between specialties. I have no idea what you mean by "same meaning".

 

[dadaddadaBATMAN]

PAs have less schooling, PERIOD. They also don't have to do residency training to hop between specialties. I have no idea what you mean by "same meaning".

What I mean is saying "I'm a cardiologist" followed by "I'm a PA" is a non-sequitur. Correct me if I'm wrong, but I believe cardiologist = 3 year IM + 3 year cardio fellowship = 6 years of "school" after med. school.

That's close to as much school after medical school as a PA gets after high school. To claim that you'll be doing the same things as a cardiologist as a PA doesn't make much sense to me. You may "do" some of the same procedures, but you aren't doing the same job. The things that would draw me to a cardiology practice (complexity of cases, mastering an organ system) would not exist as a PA.

If your goal is to do similar work, I agree you can. If you want to do a similar job, I'd disagree (job here meaning what you think, how you carry out your work).

Edit: I changed some wording and made some things more clear than my original statement.
Edit 2: misspelled sequitur. A thousand curses upon latin

 

[DermViser]

What I mean is saying "I'm a cardiologist" followed by "I'm a PA" is a non-sequitur. Correct me if I'm wrong, but I believe cardiologist = 3 year IM + 3 year cardio fellowship = 6 years of "school" after med. school.

That's close to as much school after medical school as a PA gets after high school. To claim that you'll be doing the same things as a cardiologist as a PA doesn't make much sense to me. You may "do" some of the same procedures, but you aren't doing the same job. The things that would draw me to a cardiology practice (complexity of cases, mastering an organ system) would not exist as a PA.

If your goal is to do similar work, I agree you can. If you want to do a similar job, I'd disagree (job here meaning what you think, how you carry out your work).

Edit: I changed some wording and made some things more clear than my original statement.
Edit 2: misspelled sequitur. A thousand curses upon latin

Why are you counting high school for PA but not for MD? It doesn't make any sense at all. After 2 years of PA, you can go out an practice, period. PAs do H&Ps and prescribe pills which are what cardiologists (non-interventional) do.

 

[dadaddadaBATMAN]

Why are you counting high school for PA but not for MD? It doesn't make any sense at all. After 2 years of PA, you can go out an practice, period. PAs do H&Ps and prescribe pills which are what cardiologists (non-interventional) do.

That's exactly what I'm not doing. I'm pointing out that a cardiologist has significantly more school. Probably on the line of 8 more years of it. A PA can do an H&P and prescribe pills, but I don't trust them to do it with the same ability as an actual cardiologist.

I would also say that sounds like a very watered-down version of cardiology, and a lot of people who join the specialty do it for other things..... e.g. electro, interventional.

 

[dadaddadaBATMAN]

Why are you counting high school for PA but not for MD? It doesn't make any sense at all. After 2 years of PA, you can go out an practice, period. PAs do H&Ps and prescribe pills which are what cardiologists (non-interventional) do.

I think I may have realized where the confusion was coming from: I'm focused on what makes a PA not a true "specialist" because that's what you originally asked about.

If you're also wondering what I meant by "PA/NP are not immune to this attitude," it's just that they can end up working a lot as well. What's more, they're more easily replaced and have to deal with those stresses. I think we tend to focus a lot on the benefits of those professions, and not the aspects that can really suck.

 

[DermViser]

I think I may have realized where the confusion was coming from: I'm focused on what makes a PA not a true "specialist" because that's what you originally asked about.

If you're also wondering what I meant by "PA/NP are not immune to this attitude," it's just that they can end up working a lot as well. What's more, they're more easily replaced and have to deal with those stresses. I think we tend to focus a lot on the benefits of those professions, and not the aspects that can really suck.

PAs/NPs more easily replaced? How? by the more expensive alternative - doctors? Again their investment either by time or cost is low.

 

[deleted307836]

PAs/NPs more easily replaced? How? by the more expensive alternative - doctors? Again their investment either by time or cost is low.

The poster meant that they're more easily replaced by each other, which is true, at least it generally is for inpatient positions.

 

[dadaddadaBATMAN]

PAs/NPs more easily replaced? How? by the more expensive alternative - doctors? Again their investment either by time or cost is low.

By one another. It's a consequence of investing less into the education.

Nursing has fairly high turnover, and so do physician assistants. It's not as though MDs are immune to those pressures, but we're certainly less susceptible.

As a general rule, they can find another job...that's usually not the issue. It's more a stability thing.

 

[DermViser]

Nursing has fairly high turnover, and so do physician assistants. It's not as though MDs are immune to those pressures, but we're certainly less susceptible.

As a general rule, they can find another job...that's usually not the issue. It's more a stability thing.

Yes, bc NPs and PAs move often between jobs bc they see a better opportunity. No surprise there.

 

[dadaddadaBATMAN]

Yes, bc NPs and PAs move often between jobs bc they see a better opportunity. No surprise there.

Some of the time, yes. But they are also some of the first staff to get let go when a hospital hits trouble. I'm moving out of my depth here though, so maybe one of these kind people would like to comment
@fab4fan @Promethean

Edit: sorry, you're the only two nurses I know of on this forum.

 

[DermViser]

Some of the time, yes. But they are also some of the first staff to get let go when a hospital hits trouble. I'm moving out of my depth here though, so maybe one of these kind people would like to comment
@fab4fan @Promethean

Edit: sorry, you're the only two nurses I know of on this forum.

I would say also that nursing (with respect to budget cuts) is different from NPs. Not to mention NPs tend to be more in the outpatient setting, but not always.

 

[dadaddadaBATMAN]

I would say also that nursing (with respect to budget cuts) is different from NPs. Not to mention NPs tend to be more in the outpatient setting, but not always.

True. I would still doubt whether those positions hold an MD's level of security though. They're cheaper because they are more common, which means they face more competition from one another....which undermines the job security and paycheck. If anything, the ease of "switching specialties" may make things even worse.

 

[vokey588]

Thank you for this! I am rethinking my entire decision and will most likely withdraw my interviews to pursue PA instead. I am just struggling personally with the balance of it all for medicine and where I could be happy practicing as a PA and still have a life outside of medicine

I'm not questioning your decision, but my understanding is that PAs work really hard as well. Many specialty practices have PAs see all their consults in the hospital, or at least before the MD sees them. I did half of my general inpatient rotation at a large, urban, non-academic hospital and when I had to call consults I was almost always speaking to a PA. My impression is that PAs don't work 8-5.

 

[RJGOP]

Some of the time, yes. But they are also some of the first staff to get let go when a hospital hits trouble. I'm moving out of my depth here though, so maybe one of these kind people would like to comment
@fab4fan @Promethean

Edit: sorry, you're the only two nurses I know of on this forum.

I believe @BestDoctorEver is/was also a nurse, I'm not positive though.

 

[DermViser]

I'm not questioning your decision, but my understanding is that PAs work really hard as well. Many specialty practices have PAs see all their consults in the hospital, or at least before the MD sees them. I did half of my general inpatient rotation at a large, urban, non-academic hospital and when I had to call consults I was almost always speaking to a PA. My impression is that PAs don't work 8-5.

Depends on specialty. Many PAs work in 9-5 practices. I have yet to hear of a PA taking "call". It's not in their vocabulary.

 

[vokey588]

Depends on specialty. Many PAs work in 9-5 practices. I have yet to hear of a PA taking "call". It's not in their vocabulary.

Yea the PAs I specifically am thinking of we're mostly cardiology and surgery. One of my patients had CP and ST elevation after being admitted for a different reason, and a PA saw the patient before the MD at 7pm on a weekday. This is all anecdotal of course. Could be the exception and not the rule.

It was an interesting case study of the MD vs. mid level difference. The PA called it a STEMI and thought he needed a cath, but the MD knew his EP a lot better and said it wasn't a real STEMI bc of some EKG finding I had never heard of. It looked exactly like tomb stoning though so I don't blame the pa for thinking that.

 

[BestDoctorEver]

@RJGOP ... I don't know why I am the subject of this conversation, but yes I was (am) a nurse ...

 

[DermViser]

Yea the PAs I specifically am thinking of we're mostly cardiology and surgery. One of my patients had CP and ST elevation after being admitted for a different reason, and a PA saw the patient before the MD at 7pm on a weekday. This is all anecdotal of course. Could be the exception and not the rule.

It was an interesting case study of the MD vs. mid level difference. The PA called it a STEMI and thought he needed a cath, but the MD knew his EP a lot better and said it wasn't a real STEMI bc of some EKG finding I had never heard of. It looked exactly like tomb stoning though so I don't blame the pa for thinking that.

Yes and those timings are inherent to the specialty itself - Cards and Surgery. Not surprised.

 

[RJGOP]

Yea the PAs I specifically am thinking of we're mostly cardiology and surgery. One of my patients had CP and ST elevation after being admitted for a different reason, and a PA saw the patient before the MD at 7pm on a weekday. This is all anecdotal of course. Could be the exception and not the rule.

It was an interesting case study of the MD vs. mid level difference. The PA called it a STEMI and thought he needed a cath, but the MD knew his EP a lot better and said it wasn't a real STEMI bc of some EKG finding I had never heard of. It looked exactly like tomb stoning though so I don't blame the pa for thinking that.

I'm not positive, but I think even the PAs that work in cards or surgery (with the exception of ENT) have shifts or don't work everyday. I'm sure it's not like that everywhere but I think I've seen that before. But yeah, if they work for Derm or ENT, for example, that's probably very uncommon.

 

[BestDoctorEver]

I'm not questioning your decision, but my understanding is that PAs work really hard as well. Many specialty practices have PAs see all their consults in the hospital, or at least before the MD sees them. I did half of my general inpatient rotation at a large, urban, non-academic hospital and when I had to call consults I was almost always speaking to a PA. My impression is that PAs don't work 8-5.

That is what I saw when I used to be in nursing... Most PA don't work 8-5 and call it a day... They complain as much as physicians.

 

[RJGOP]

@RJGOP ... I don't know why I am the subject of this conversation, but yes I was (am) a nurse ...

Sorry, I was just pointing out, as the discussion had swayed to nurses on this forum, that you were also a nurse.

 

[DermViser]

I'm not positive, but I think even the PAs that work in cards or surgery (with the exception of ENT) have shifts or don't work everyday. I'm sure it's not like that everywhere but I think I've seen that before. But yeah, if they work for Derm or ENT, for example, that's probably very uncommon.

The timing commitments of PAs are different in general and it's expected for their profession. Hospitals know this. PAs can be Ortho PAs one day and then change and become a Derm, Allergy, or ENT PA.

 

[Doctor Bob]

I have yet to hear of a PA taking "call". It's not in their vocabulary.

The ortho groups where I did residency would have their PAs take call. When you called the service at night you got a PA. If they felt they couldn't answer the question then they called the orthopod.
The cardiology group did the same thing. The answering service would call the PA first, then the attending only if the PA didn't give the consulting doc a satisfactory decision.

At one of the hospitals I worked at in Texas, when you paged the neurosurgery group overnight, the first responder was a PA. Same algorithm as above. Only it took us a while to figure out that the PA wasn't actually a physician, because they'd never ID themselves on the phone.

 

[BestDoctorEver]

I'm not positive, but I think even the PAs that work in cards or surgery (with the exception of ENT) have shifts or don't work everyday. I'm sure it's not like that everywhere but I think I've seen that before. But yeah, if they work for Derm or ENT, for example, that's probably very uncommon.

PA in derm is not uncommon in South FL

 

[RJGOP]

The timing commitments of PAs are different in general and it's expected for their profession. Hospitals know this. PAs can be Ortho PAs one day and then change and become a Derm, Allergy, or ENT PA.

I was referring to the ones that only work within one specialty. But yeah, you're right.

 

[BestDoctorEver]

Sorry, I was just pointing out, as the discussion had swayed to nurses on this forum, that you were also a nurse.

That is ok... I guess it's a case of the grass is greener... But after speaking with former nursing school classmates who are (NP/ and even Pharmacists), I have concluded that med school (psychiatry) will be a better bang for my bucks...

 

[dadaddadaBATMAN]

@RJGOP ... I don't know why I am the subject of this conversation, but yes I was (am) a nurse ...

It was from earlier. I was commenting on nurse turnover rates, and I felt like I'm not as qualified as an actual nurse to talk about that. RJGOP was kind enough to point out you are also a nurse.

It was just an invitation for others to join the conversation, thanks for doing so!

 

[DermViser]

PA in derm is not uncommon in South FL

Not surprised. They have a NP Derm "residency" down there as well.

 

[DermViser]

That is ok... I guess it's a case of the grass is greener... But after speaking with former nursing school classmates who are (NP/ and even Pharmacists), I have concluded that med school (psychiatry) will be a better bang for my bucks...

You know there are Psych NPs, right?

 

[SouthernSurgeon]

I'm not positive, but I think even the PAs that work in cards or surgery (with the exception of ENT) have shifts or don't work everyday. I'm sure it's not like that everywhere but I think I've seen that before. But yeah, if they work for Derm or ENT, for example, that's probably very uncommon.

Ours work 40 hours per week in shifts. So if they do longer shifts, they work fewer than 5 days per week.

But the longer shifts are advantageous to necessary, since it's not super helpful to have a midlevel come in hours after rounds and try to play catch-up.

 

[BestDoctorEver]

You know there are Psych NPs, right?

I know... But I was not impressed about the curriculum of a couple of schools that I looked at... I understand there is opportunity cost involved, but I ultimately want to be the specialist (not the mid level)... Also, med school debt will be the only big debt I will have by the time I am done with residency. I am a low maintenance guy. 90k-120k as a psych NP vs. 200-250k as a psych physician certainly did not make the decision too hard either...

NB...You are probably right in some aspects as well... If someone can't stomach the 'brutalness' of med school, NP/PA is not a bad choice...

 

[BestDoctorEver]

I know... But I was not impressed about the curriculum of a couple of schools that I looked at... I understand there is opportunity cost involved, but I ultimately want to be the specialist (not the mid level)... Also, med school debt will be the only big debt I will have by the time I am done with residency. I am a low maintenance guy. 90k-120k as a psych NP vs. 200-250k as a psych physician certainly did not make the decision too hard either...

....

 

[Promethean]

Some of the time, yes. But they are also some of the first staff to get let go when a hospital hits trouble. I'm moving out of my depth here though, so maybe one of these kind people would like to comment
@fab4fan @Promethean

Edit: sorry, you're the only two nurses I know of on this forum.

Aw, man... I was trying to stay out of this thread. But, since you asked:

As a nurse, my job is fairly safe from economic downturns. I am not the first person to be laid off. There are always ancillary and supportive staff that can be let go, with nurses expected to pick up their duties at no additional pay. When the hospital cuts staff, it means that I will do the janitorial work, restock supply rooms, and generally do labor far below my pay grade... in addition to all the nursing care that I am still expected to provide at the same time. (To be clear, I am not one of those nurses who believes that having a license makes me incapable of mopping a floor. I regularly pitch in and assist anyone with their work if mine is done. What I resent is when the entire OR is slowed to a halt because the hospital doesn't want to pay even 1 more patient transport person to get the patients down to us within an hour of when we call for them. 2 transporters for a 500 bed facility is a recipe for inefficiency throughout the building.)

That said... if there is a conflict between me and a physician, I will be fired long before the doctor. I have seen it happen, as no fewer than 3 nurses were driven out of our OR by a particularly abusive surgeon, and I may become the 4th if no one else beats me to the honor. He is allowed to behave in ways that endanger patients, and to be verbally and even physically abusive to staff. However, he is a rockstar neurosurgeon, who earns millions upon millions for the hospital every year. He is seen as a profit center. Nurses and anesthesiologists are seen as cost centers. I've even seen a radiologist (cost center) lose her job for standing up for one of her techs in a conflict with this surgeon. At least once a year a formal complaint is filed, yet somehow, he is able to persist. I really don't understand it given that our facility gives so much lip service to creating a safe culture for staff.

That kind of job security isn't the draw of medicine for me. Rather, it is another reason to choose a specialty (Family Med) that I can practice far away from hospital administrators.

 

[BestDoctorEver]

Not surprised. They have a NP Derm "residency" down there as well.

Where in S. FL is that residency? lol

 

[BestDoctorEver]

@Promethan

That said... if there is a conflict between me and a physician, I will be fired long before the doctor. I have seen it happen, as no fewer than 3 nurses were driven out of our OR by a particularly abusive surgeon, and I may become the 4th if no one else beats me to the honor. He is allowed to behave in ways that endanger patients, and to be verbally and even physically abusive to staff. However, he is a rockstar neurosurgeon, who earns millions upon millions for the hospital every year. He is seen as a profit center. Nurses and anesthesiologists are seen as cost centers. I've even seen a radiologist (cost center) lose her job for standing up for one of her techs in a conflict with this surgeon. At least once a year a formal complaint is filed, yet somehow, he is able to persist. I really don't understand it given that our facility gives so much lip service to creating a safe culture for staff.

That kind of job security isn't the draw of medicine for me. Rather, it is another reason to choose a specialty (Family Med) that I can practice far away from hospital administrators.

Nothing new about surgeons behaving badly... Everyone knows since surgeons bring a lot of money to the hospitals, they usually let them get away with bad 'behaviors'... Creativing a safe culture is probably the BS that every place uses as their motto, but most won't back up that rhetoric if it will affect their bottom line...

 

[DermViser]

Ours work 40 hours per week in shifts. So if they do longer shifts, they work fewer than 5 days per week.

But the longer shifts are advantageous to necessary, since it's not super helpful to have a midlevel come in hours after rounds and try to play catch-up.

😱

 

[DermViser]

Where in S. FL is that residency? lol

At the University of South Florida thru their nursing school. Definitely NOT with USF's allopathic derm residency. Likely with private practice derms.

 

[NervousNerd]

I'm going to chime back in since I did start this whole PA conversation.

I've done a ton of reading lately. As I see it, there are a number of specialties where I could still maintain fairly good work-life balance. (Derm, optho, anestis, rads, psych).

I've done some reading where they say they do 8-5or6 and have very little to no call. Some even manage to do a 4 day work week.

Opinions?

Also, for me to go PA, I would have to significantly boost clinical hours, take a few pre reqs. Thus with the required gap year as well as application year and 3 years of PA school: 5 years from graduation to get PA versus 4 years after graduation to get MD....

 

[DermViser]

I'm going to chime back in since I did start this whole PA conversation.

I've done a ton of reading lately. As I see it, there are a number of specialties where I could still maintain fairly good work-life balance. (Derm, optho, anestis, rads, psych).

I've done some reading where they say they do 8-5or6 and have very little to no call. Some even manage to do a 4 day work week.

Opinions?

Also, for me to go PA, I would have to significantly boost clinical hours, take a few pre reqs. Thus with the required gap year as well as application year and 3 years of PA school: 5 years from graduation to get PA versus 4 years after graduation to get MD....

Those specialties are competitive (besides Psych, for now) for a reason. And no Anesthesiology is not really a "work/life balance specialty".

 

[fab4fan]

True. I would still doubt whether those positions hold an MD's level of security though. They're cheaper because they are more common, which means they face more competition from one another....which undermines the job security and paycheck. If anything, the ease of "switching specialties" may make things even worse.

Most physicians aren't employees of the hospital, which gives them a certain degree of security. An NP or PA that's an employee of the hospital would be seen as a "provider," meaning they have the potential to bring in $$$, so they also have some security.

Nurses are often on the chopping block because they're considered a financial drain. They don't bring in business, though it could be argued that hospitals with crappy nursing care suffer from low census as opposed to hospitals with better nursing care.

Is that the answer you were looking for, Batman?

 

[dadaddadaBATMAN]

Most physicians aren't employees of the hospital, which gives them a certain degree of security. An NP or PA that's an employee of the hospital would be seen as a "provider," meaning they have the potential to bring in $$$, so they also have some security.

Nurses are often on the chopping block because they're considered a financial drain. They don't bring in business, though it could be argued that hospitals with crappy nursing care suffer from low census as opposed to hospitals with better nursing care.

Is that the answer you were looking for, Batman?

Thank you for the response, I really appreciate it 🙂!

Not necessarily looking for any particular answer, just hoping for something better than my hypothetical BS. I can pontificate all day about the woes of nursing, but the reality is that I don't know jack-squat.

 

[Great White Buffalo]

Yes this would be the goal. Time to find out if I am even a competitive PA applicant...

PA programs usually require 1,000-2,000 hours of clinical work before you can apply. Check out requirements. So, you are going to waste another year working at some menial clinicl job to get the hours, then go to PA school for 2 years. That is a 3 year investment, though the workload is a lot easier.

 

[DermViser]

PA programs usually require 1,000-2,000 hours of clinical work before you can apply. Check out requirements. So, you are going to waste another year working at some menial clinicl job to get the hours, then go to PA school for 2 years. That is a 3 year investment, though the workload is a lot easier.

1 year is nothing, when med students end up taking gap years.

 

[saada9]

Need some advise please!
i graduated with a 3.1 gpa in biology. my last two semesters i got 3.50 gpa and made the dean's list.
im disadvantaged, migrating to the US knowing only arabic and living with 7 siblings with the help of the government assitance.
I did 6 months interning at ecology lab at SDSU
6 months internship at surgical acute care at a hospital
6 months shadowing my family physician
currently volunteering at MICU at Sharp hospital
1 year helping elementary school stay active and helping with their homework
Currently studying for the Mcat
What are my chances of getting into medical school after my mcat?

 

[Ismet]

Need some advise please!
i graduated with a 3.1 gpa in biology. my last two semesters i got 3.50 gpa and made the dean's list.
im disadvantaged, migrating to the US knowing only arabic and living with 7 siblings with the help of the government assitance.
I did 6 months interning at ecology lab at SDSU
6 months internship at surgical acute care at a hospital
6 months shadowing my family physician
currently volunteering at MICU at Sharp hospital
1 year helping elementary school stay active and helping with their homework
Currently studying for the Mcat
What are my chances of getting into medical school after my mcat?

This is not the place to post this. There is a "what are my chances?" Forum over in pre-Allo where you can create a thread.

 

[Kale01]

if it is not that hard to get into then you should have been admitted in the first place. That's like saying neurosurgery is a piece of cake.

Why did you turn this into a conversation about me? Fwiw, I did get admitted....I graduated as salutatorian of my high school class. Getting into a top undergrad is easy. If you think getting into Cornell undergrad is hard, wtf were you doing in high school? High school was a joke.

I think you're missing the point. Pursuing finance is different from "attending a random ivy league college." Lots of people do the latter but don't pursue finance and don't make as much money.

 

[Mskincer]

Why did you turn this into a conversation about me? Fwiw, I did get admitted....I graduated as salutatorian of my high school class. Getting into a top undergrad is easy. If you think getting into Cornell undergrad is hard, wtf were you doing in high school? High school was a joke.

I think you're missing the point. Pursuing finance is different from "attending a random ivy league college." Lots of people do the latter but don't pursue finance and don't make as much money.

good job on the humble brag. maybe your high school was a joke, handing out A's faster than Mcdonalds can make fries but my high school was tough and it cost some students a spot at some of the higher ranked schools despite having a stellar GPA.

if you're sold on finance, you would have done it, if its that easy then a medical student should have an easy transition into finance like you.

 

[Psai]

Why did you turn this into a conversation about me? Fwiw, I did get admitted....I graduated as salutatorian of my high school class. Getting into a top undergrad is easy. If you think getting into Cornell undergrad is hard, wtf were you doing in high school? High school was a joke.

I think you're missing the point. Pursuing finance is different from "attending a random ivy league college." Lots of people do the latter but don't pursue finance and don't make as much money.

It's pretty tough to get into a good undergrad, especially depending on your race