Why did you become a PA opposed to going to medical school?

tony1853

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    As I have mentioned in my first post, I have ended my business career to complete a PA BS program. My wife really feels I should "go all the way" (her phrase) and complete bio degree, and then apply to med schools.

    I was wondering if some of you would like to share your reasons for becoming a PA opposed to a doctor.

    Thanks. :)
     

    dermpa02

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      In my PA class there were quite a few who were starting second and third careers, myself included. I and several of my friends discussed this same question, and the general concensus is that we were not inclined to spend many more years in training before we could actually work again.

      Cost was also a concern of others as well. Many did not want to be in the kind of debt that you will many times see with med students.

      Phil
       

      tony1853

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        Hi Phil,

        Those are pretty much my reasons. As it stands right now, I have to finish 3 liberal arts courses, and the required biology, chemistry, math, and physics courses...so I am looking at full-time semesters + summer sessions. I would be able to enter the hospital component in August of '07...spend 2 years there, so I am done in 2009!

        If I wanted to go the med school route, it would take the same 3 semesters to finish my BS, and then 4 yrs of med school...

        I don't want to wait that long before I can actually work...and as it is, the time that I spend in school/in hospital is time that we are living only on my wife's tiny salary, a.k.a. struggling to keep our heads above water.

        dermpa02 said:
        In my PA class there were quite a few who were starting second and third careers, myself included. I and several of my friends discussed this same question, and the general concensus is that we were not inclined to spend many more years in training before we could actually work again.

        Cost was also a concern of others as well. Many did not want to be in the kind of debt that you will many times see with med students.

        Phil
         
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        hospPA

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          The reason I chose PA school instead of attempting to do medical school is time. I reached a point in my life where having a wife and family, as well as time to spend with them was and and still is the most important thing to me. Being a PA is a great balance between the two. My wife and I are both PA's and make more together than we would on one physician's salary (OK, maybe not thoracic surgery or IR :D ). If I was a doc, I likely would be the only one working, as someone would have to stay home and watch the kids while I worked 80 hours a week. Now, we each work 40 and are happy with our time available as well as income. Nether if us feel the need to "be the boss". If you do, go to medical school.

          Pat
           

          cecilia

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            Hi,

            I also chose PA because of time and expenses. I was already 32 and I would have had to repeat courses that I already took. I was a chiropractor. I did not want to go through the same first two years. I also want to have more kids and spend time with my family. I know that is very hard to do while you are in a residency. During my rotations, I met a couple of docs: One of them had two small kids and she saw them every six weeks..they lived in another city with their dad (they were not separated) and the other one had a newborn and was thinking about quitting the residency because she could not spend anytime with the baby. She was already half way through.
            But I guess if you don't have any kids and your spouse is strong and willing to support you, then go ahead and do it. It is a tough decision. Good luck.

            -Cecilia
             

            MARINE

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              I'm also married, and have two small sons. The PA career path looks great to me. I am currently a Marine working on my pre-requisites and EMT certification so I have some hard work ahead me to get to and through PA school. Recently I read a string of messages from PA's on a forum like this all talking about their desire to be more like MD's or have a doctor title and the possible end of PA's due to NP's taking their jobs. I am new on this path and have no medical background outside of CPR and 1st Aid courses in the Marine Corps so is there a PA or MD here that sees things the same way?

              -Ted
               
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              deleted6669

                Pa's Will Be Around For A Long Time. They Are Expected To Be The 2nd Fastest Growing Medical Career(after medical asst) Over The Next 10 Yrs In # Of New Jobs With A Doubling In Total # Of Working Pa's By 2010 To 80,000 So Your Future Is Safe If You Go That Route :)
                 

                hospPA

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                  emedpa said:
                  Pa's Will Be Around For A Long Time. They Are Expected To Be The 2nd Fastest Growing Medical Career(after medical asst) Over The Next 10 Yrs In # Of New Jobs With A Doubling In Total # Of Working Pa's By 2010 To 80,000 So Your Future Is Safe If You Go That Route :)

                  I agree entirely. It is a great profession to get into. Those folks who go from PA to medical school are people who are generally uncomfortable with the limitations of being a PA versus being a doc. If you feel that may be you, then consider med school. For me, I am quite comfortable.
                  Pat
                   

                  CTS-PA

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                    "I was wondering if some of you would like to share your reasons for becoming a PA opposed to a doctor"

                    When I chose this career path in my junior year of highschool, I could have spouted off all the things I was supposed to say to an ADCOM. Now, after being PA for about three years and I can tell you why it has really worked out for me. 1. Compared to someone graduating from Medical School I have less debt, 2. I was able to start working as a PA and living my life at the point most people my age were applying to medical school, 3.I have a good handle on my schedule, sometimes I work a lot and sometimes I don't; at the end of the day I make the decision and that's the best part. Like HospPA said in an earlier post I am comfortable with my scope of practice and what I do. When all is said and done in healthcare as a PA/MD/RN etc. you get to do something challenging, and help people while you do it.
                     

                    Febrifuge

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                      CTS-PA said:
                      ...after being PA for about three years and I can tell you why it has really worked out for me. 1. Compared to someone graduating from Medical School I have less debt, 2. I was able to start working as a PA and living my life at the point most people my age were applying to medical school, 3.I have a good handle on my schedule, sometimes I work a lot and sometimes I don't; at the end of the day I make the decision and that's the best part.
                      See, as a potential PA student (or a potential med student, still flip-flopping on that), these are some very powerful and compelling ideas. Thanks for the real-life examples, they really help in this stage of things when it's all so preliminary and abstract.

                      But I've had people tell me that the debt-load and the time factor shouldn't really be very strong considerations in the decision, because in the long run these things will work out. Better to suffer through 7 or 8 years now, than to get out there working in 3 years and then find yourself looking toward med school again, in another 8 or 10 years. So, not to be a downer, but do you have a high degree of confidence that the way you feel now, 3 years out of school, is likely to be the same in the future?
                       

                      PACtoDOC

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                        Febrifuge said:
                        See, as a potential PA student (or a potential med student, still flip-flopping on that), these are some very powerful and compelling ideas. Thanks for the real-life examples, they really help in this stage of things when it's all so preliminary and abstract.

                        But I've had people tell me that the debt-load and the time factor shouldn't really be very strong considerations in the decision, because in the long run these things will work out. Better to suffer through 7 or 8 years now, than to get out there working in 3 years and then find yourself looking toward med school again, in another 8 or 10 years. So, not to be a downer, but do you have a high degree of confidence that the way you feel now, 3 years out of school, is likely to be the same in the future?

                        Great post. I graduated PA school in 98 and have worked since, but I will graduate from med school next year. James D, that quote about the person from PCOM was humorous, There are hundreds of MD/DO applicants a year that don't match, but that means nothing in the grand scheme of their existence. They ALL scramble into a program that also did not fill all their applicants, thus it is no issue. A DO guarantees you not only the same opportunities as an MD, but even more at times. As a DO applicant, the application cycle has not even started for the 2006 match and I have MD residencies all over the place asking me to consider signing outside the match instead of entering the match. And PCOM is a premier institution that has grads at Hopkins, Stanford, Mayo, Duke, Harvard, Brigham and Women's, etc... That quote was off the money.

                        Bottom line, you better know damn certain you can handle being a PA forever if you go that route, otherwise you will be adding more time and money to fix a mistake later. At least when I did it PA school was a BS degree so I lost no real time that route other than my working years. And don't let the debt thing or time factor fool you. Your lifetime earning potential as well as lifetime working hours will be better as a physician. My doc I worked for worked 20 hours a week while I worked 50. He made 350K a year off his 2 PA's and himself. See the logic there?

                        And Pat, the 80 work week doesn't hold water except for surgical and specialty residencies, and a very select number of rotations in a primary care residency. On medicine right now I pull 80 hours a week, but it is actually quite nice.

                        Picture this schedule.
                        Call Q4, meaning I come in at noon that day and leve the next day around 3PM. Every other day when not on call I come in at 6:30 and am out by noon. When I take my one day a week off, I take it pre-call which actually ends up giving me 48 straight hours off. The large number of hours in residency are spent on these call nights where you might actually get some sleep. An 80 hour work week does not mean that you average that out and work 11.5 hours per day, such as 6AM to 5:30PM daily. Like I said, when I am not on call, I have an entire half day each day to myself, to play with my kids, etc.. And this is only on medicine. On FP service and outpatient clinic rotations, the same 40-50 hour PA schedule exists. In this schedule I still moonlight like 4-10PM 7-8 times a month, so a residents salary can easily go from 42K to 70-80K!!! To be quite frank, I don't know one resident that I have met that does not make more than the average PA when it washes out. You can't use salaries like EMEDPA's as a guide because this guy is a pro and is in the top 1%. But in truth he should be a doctor and he knows it!!! ;)

                        If you want to be a PA, do it for this reason only. Do it because you honestly don't want the rigorous academic challenge of 2 years of trenchwork, 2 years of clinic work, 3 years of residency, and at minimum 10 different MAJOR standardized exam/Board exam like tests to get your license. PA requires ONE major standardized test to get your license. That is the real difference

                        And Oh my God, who is the chiropractor saying that his first 2 years of chiropractor school would be the same as the first 2 years of medical school and that he "did not want to repeat it"? Well what do you think it will be in PA school, some new medical stuff that was somehow left out of my first 2 years of medical school? You are sniffing some serious paint fumes if you think your first 2 years of chiro school are anything similar to the pathophy, pharm, physio, histo, molecular bio, biochem, clinical medicine that we get in medical school. I hate to burst your bubble bone-cracker but even PA school is going to be an eye opening experience for you in terms of "real medicine". I knew a chiro that dropped out of PA school because it kicked his royal ass. He had been accepted to chiro school with only 90 college credits and a GPA of 2.7, and an MCAT of 16 (not required for chiro admission but shows level of intelliegence!). I now have a chiro in my school who is an MS1 and he is struggling and happily admits the material is WAY harder than his chiro-mess.
                        Stop BSing people and give the real reason you are going to PA school. Just admit you don't want the academic challenge like I stated above. That answer is honest and reasonable, but stop blowing smoke up people's behinds!!
                         

                        cecilia

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                          Hi, I am the chiro that said that did not want to repeat any more classes.
                          PA school for me was very easy, while everyone else in my classroom had to struggle really hard. I am the only one that is able to say really weather chiro school was difficult or not or if PA school was difficult or not...because I attended both. It is both very ignorant of people to think that they can have an opinion of something they have no idea about. That goes for chiros having opinions on the medical field and for some medical practitioners having an opinion on chiropractic education.
                          I found that for except pharmacology and the clinical rotations, the other classes were pretty much a copy of the ones I had in chiro school. In fact, I had some classes at chiro school like neuroanatomy lecture and lab (which I did not have in PA school) that were very challenging.
                          And I said I did not want to repeat any more courses because I had taken simple courses like anatomy and physiology,microbio, etc...more than once because I also have a bachelors in biology. And also a masters in clinical nutrition. I don't want to spend more time in school!!
                          Just a word of advice...to Pactodoc....get down from your high horse and learn to appreciate other health care practitioners too.
                           
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                          PACtoDOC

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                            cecilia said:
                            Hi, I am the chiro that said that did not want to repeat any more classes.
                            PA school for me was very easy, while everyone else in my classroom had to struggle really hard. I am the only one that is able to say really weather chiro school was difficult or not or if PA school was difficult or not...because I attended both. It is both very ignorant of people to think that they can have an opinion of something they have no idea about. That goes for chiros having opinions on the medical field and for some medical practitioners having an opinion on chiropractic education.
                            I found that for except pharmacology and the clinical rotations, the other classes were pretty much a copy of the ones I had in chiro school. In fact, I had some classes at chiro school like neuroanatomy lecture and lab (which I did not have in PA school) that were very challenging.
                            And I said I did not want to repeat any more courses because I had taken simple courses like anatomy and physiology,microbio, etc...more than once because I also have a bachelors in biology. And also a masters in clinical nutrition. I don't want to spend more time in school!!
                            Just a word of advice...to Pactodoc....get down from your high horse and learn to appreciate other health care practitioners too.


                            Perhaps you should take your own advice and not try and evaluate a program you have never been through. To say that you did not want to repeat courses implies you are assuming that your chiro courses were equal to med school courses. Have you been to medical school Cecilia? Well since not, you will never know if your chiro courses are equal. But I can tell you Cecilia, because I have personal friends who are chiros in my school, that they all have told me that there is no comparrison. They said they spent more time on "marketing" than they ever did in true basic sciences. And if your chiro courses were a mirror image of PA courses, then your courses were again of no comparison to med school. No high horse here chiro, I just don't like people using subtly inserted messages to insenuate that their courses are equal to med school. I have heard fellow PA's try to say this, and I always call them on it, just like I am calling BS on you.
                             
                            Why are so many other health care providers trying to compare their core science training to med school core science training?? There are many errors in doing this, but the most obvious is to assume the science med students get taught is somehow the gold standard. Any PhD in biochem, molecular bio etc.. will have eclipsed the science traing of any MD well before they graduate, but I don't see PAs, chiros etc comparing their core science training the these folks who are truly scientists. MD/DO training is the most comprehensive to treat the human body; there is no denying that. However, medical training does not make one a chiro, psych, PA, NP etc...
                            This back and forth is really quite ridiculous.

                            :cool:
                             

                            Febrifuge

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                              In an attempt to get the thread back on track, I'll ask this one for the working PA's: when you were a student, did you enjoy the sort of horrific abuse and pimping that med students tell tales of? I'm taking it for granted that most PA-S's are right alongside their MSIII and MSIV compatriots on the wards. So I would imagine that either the pimping is worse, because residents and docs who abuse med students are no less likely to abuse PA students... or else maybe it's not as bad, since the "House of God" mentality that leads them to punish med students for the crime of being med students might apply to a lesser extent (in the abuser's mind) to the future PA.

                              Any comments or horror stories on that?
                               

                              cecilia

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                                Hi,

                                No horror stories here. I can only speak for myself in that I had a very nice time during all my rotations. For some reason all the residents and even the attendings were very respectfull towards me. However, I do know that some of my classmates did not do as well with them.
                                There were a couple of instances on a few rotations where I had to stand there and watch how the attendings were mentally abusing the residents even insulting them in front of medical stuff and patients. That was very uncomfortable. I thought that maybe one of the residents might come with a rifle the next day and shoot him. Hopefully, that did not happen...what did happen is more than one resident would talk about the attendings almost trashing him behind their backs. I guess that is normal in that environment.

                                -Cecilia
                                 
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                                deleted6669

                                  Febrifuge said:
                                  In an attempt to get the thread back on track, I'll ask this one for the working PA's: when you were a student, did you enjoy the sort of horrific abuse and pimping that med students tell tales of? I'm taking it for granted that most PA-S's are right alongside their MSIII and MSIV compatriots on the wards. So I would imagine that either the pimping is worse, because residents and docs who abuse med students are no less likely to abuse PA students... or else maybe it's not as bad, since the "House of God" mentality that leads them to punish med students for the crime of being med students might apply to a lesser extent (in the abuser's mind) to the future PA.

                                  Any comments or horror stories on that?
                                  feb- treated the same on every rotation as med students-e
                                   

                                  BackTalk

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                                    I haven’t gone through this whole thread so forgive me if I ask questions that have already been answered. I’m curious as to what duties you have as a PA? Are you pretty much on your own? I know you practice under a physician but when is the line drawn as far as what your able to do? We have a clinic in town that has 2 MD’s and about 4 PA’s. Its seems that the PA’s pretty much run the place. One of them practices quite a bit of dermatology removing cancerous moles. I don’t know if that is within your training but I would think it might get the Dermatologists a little peeved. Most of the patients I treat that go to this facility never see the doctor, in fact most of them don’t know who their doctor is as they always see the PA.
                                     
                                    D

                                    deleted6669

                                      BackTalk said:
                                      I haven’t gone through this whole thread so forgive me if I ask questions that have already been answered. I’m curious as to what duties you have as a PA? Are you pretty much on your own? I know you practice under a physician but when is the line drawn as far as what your able to do? We have a clinic in town that has 2 MD’s and about 4 PA’s. Its seems that the PA’s pretty much run the place. One of them practices quite a bit of dermatology removing cancerous moles. I don’t know if that is within your training but I would think it might get the Dermatologists a little peeved. Most of the patients I treat that go to this facility never see the doctor, in fact most of them don’t know who their doctor is as they always see the PA.
                                      I work in an em setting(not primary care) and have for many years so take that into account. I see the majority of pt types presenting to the er and end up seeing a bit of everything because I work solo nights a few times a month. when working with an md/do if a critical elderly train wreck pt comes in with multiple problems they will typically start the workup on these folks as I would likely consult them anyway. for bread and butter medical and trauma cases to include mi's, syncope, dka, etc I will oversee the entire workup and disposition. the pa's at my facility manage the majority of mild to moderate trauma pts with the obviously critically ill multisystem trauma pts seen first by the er doc then the trauma surgical team.pts who are admitted have charts reviewed by an md by the end of shift. regarding review of pts d/c home this varies by facility. at one facility I work at I have to submit 10% of charts (chosen by me-usually the interesting stuff- within one month).at another facilty they routinely review all charts within 24 hrs. it all depends on the individual pa and the relationship they have with their supervising md. at another facility I did not even meet my supervising md of record for 2 years and other members of the group did thje majority of my chart review. some places want an md on scene at all times a pa is working. other places have no such requirement and the pa's can work solo with the only supervison by review of emailed/faxed charts. there are as many arrangements as there are working pa's.
                                      the analysis of suspicious skin lesions by punch or shave biopsy is certainly within the scope of any pa. primary care pa's frequently eval and tx documented basal cell carcinoma and specialty practice derm pa's trained either through residency or on the job perform more complex procedures involving squamous cell and melanoma type skin ca's. a few high end derm pa's even do MOHS procedures.
                                      hope that helps-e
                                       

                                      CTS-PA

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                                        "Just admit you don't want the academic challenge like I stated above."
                                        Not true. There are a lot of false over-bearing generalizations in these threads (see next quote).

                                        "I don't know one resident that I have met that does not make more than the average PA when it washes out"
                                        Not true, this depends on the practice setting and specialty the PA is working in and how long they have been practicing.

                                        "Do you have a high degree of confidence that the way you feel now, 3 years out of school, is likely to be the same in the future?"
                                        Yes, I do.

                                        "When you were a student, did you enjoy the sort of horrific abuse and pimping that med students tell tales of?"
                                        I worked side by side with med students and residents and I enjoyed the same treatment; both good and bad.

                                        "I’m curious as to what duties you have as a PA? Are you pretty much on your own? I know you practice under a physician but when is the line drawn as far as what your able to do?"
                                        While in the CT-ICU and Stepdown Unit, I manage pts preop and postop and anything I have a question on I run it by the Intensivist. The team (Intensivist MD, PA, RT, Charge Nurse) rounds together once in the am and the Intensivist co-signs our notes (not becuase it's mandatory but because they can then bill for them.) The PAs perform all invasive procedures (Swans, Lines, Chest Tubes, Balloon Pumps, Thoracentesis) independantly, but have the Intensivist MD in house for back up. In a code situation, if the surgeon is not in house, we (PAs) are credentialed to open up a chest, ironically our back up intensivist MDs at our institution are not credentialed to do this.
                                        While in the OR, our primary responsibility are to first assist and second assist the surgeon. One surgeon and 1 or 2 PAs scrub into each case depending on what it is (valve/cabg/aorta/congential defect etc.) For example, in a CABG, one of the PAs harvests and prepares the arterial or venous conduits then second assists, while the other PA first assists. Depending on the Surgeon and the experience level of the PA our intraoperative responsibilities varies (i.e. we do all maneuvers from our side and function autonomously). For more info on PAs in Cardiovascular and Thoracic Surgery check out www.apacvs.org and for more info on scope of practice for PAs in other specialties check out www.aapa.org.

                                        I hope that helps.
                                        _______
                                        CTS-PA
                                         

                                        PACtoDOC

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                                          "I don't know one resident that I have met that does not make more than the average PA when it washes out"
                                          Not true, this depends on the practice setting and specialty the PA is working in and how long they have been practicing.

                                          If I am not mistaken, THE AVERAGE PA salary would be compiled by including the PA's who make 300K per year, so my statement is more true than your rebuttal. I did not say every PA, but evidently that is how you interpreted it.

                                          And from what I have seen as a PA student, and now as a med student, is that the residents and attendings do sometimes expect more from the med students than from the PA students. One thing a PA student doesn't realize is that at the end of each rotation, medical students not only have to make a passing grade on the rotation, but they also have to pass the school's internal exam (like PA's often times), as well as we have to take a National board exam on that particular topic called a SHELF exam. EVERY shelf exam I have taken in 3rd year of medical school was indeed way harder than any single exam I took in PA school or the PANCE, which is a joke of an exam.

                                          As a PA student you may think you are getting the same treatment, but there are just some things a resident does not normally expect a PA to know. Sometimes they say things when the PA students are not around that reflects this attitude. I have seen this in at least 3 major teaching institutions and I am sure it happens elsewhere. Any PA who can tell you that they completed the same 3rd year of medical school that med students do is not being honest with themself. No PA took 7 SHELF exams that year, and no PA had to do all this while they were completing their residency applications, personal statements, tracking down LOR's, and finishing it off by taking Step 2 of the USMLE and COMLEX. To me, that is why any bridge program from PA to medical school would have to require at least 2 full years of school, to include 3rd year completely with Shelfs and boards, as well as a combination of year one and two stuff that was omitted.
                                           
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                                          deleted6669

                                            "To me, that is why any bridge program from PA to medical school would have to require at least 2 full years of school, to include 3rd year completely with Shelfs and boards, as well as a combination of year one and two stuff that was omitted."

                                            sounds good to me....I would be 1st in line for such a program...just don't make me take biopyschosocial issues in patient care and ethics again........
                                             
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