Medical With recent changes, should I pursue PA over DO School?

[MusicDOc124]

Hi. It's getting close to the end of the cycle and I was wondering if I could get some advice. I have currently been accepted to 4 DO schools. One DO I have been accepted to is an original 5 and 2 are pretty established branches. I have had 3 MD interviews and heard nothing yet except one waitlist. I applied thinking DO was very similar to MD, the only difference was ENT, urology, derm, and ortho were off the table. This didn't really upset me since I am not a surgery or bust person. But as I have been looking at this forum it seems like opportunities for DOs are starting to look pretty grim with the merger and it seems like only primary care is available now. Also with all of the new DO schools opening it seems like the degree is getting saturated. I want to go into OBGYN as of now. But I have seen from these threads how even a solid DO applicant can have problems trying to get into good OBGYN programs.

I have been talking to my friends in PA school and it seems like PA programs give you more freedom to specialize. I don't care about not being top dog or the salary. My GPA is a 3.9 and my MCAT is a 506 (127/126/127/126). I was wondering since my GPA is high and I took a practice GRE (without studying) and got a 85 percentile if going the PA route would be better suited for me since I have more control over what I can specialize in. I just don't want to spend 4 years in DO school and end up in a specialty I don't like. I'm not very interested in FM or Peds after shadowing those doctors. I already have my CNA certification so I was thinking I could either get my clinical hours up and apply for PA school or get my MCAT up and apply again MD.

If any DOs could please let me know what the outlook for DO seems like it will be in the future, I would really appreciate the input. I have just talked to a couple of DO students who feel like their chances of matching into anything other than primary care are pretty slim. They told me since my GPA is high I should just try for an MCAT retake. Any recommendations would be great.

Thanks!

Re: "But as I have been looking at this forum it seems like opportunities for DOs are starting to look pretty grim with the merger and it seems like only primary care is available now."

This is false. Nearly half of DOs specialize, and keep in mind internal medicine is considered primary care, but required for anyone who wants to be a cardiologist, GI doc, heme/onc, etc. There is also some self-selection for DO with wanting to be primary care from the get-go. There are numerous MD schools that have higher output of primary care doctors than plenty of DO schools as well. What you can do will be almost entirely up to your boards (though this just changed for EVERYONE today in that Step 1 will be pass/fail in 2022).


Re: "I have just talked to a couple of DO students who feel like their chances of matching into anything other than primary care are pretty slim."

They must not have performed well. I did not feel this way and have been quite successful. A lot of my friends have matched into ACGME surgery, academic IM, anesthesia, EM, etc including Johns Hopkins, Jefferson, Penn, and numerous other "big names" as well as plenty of solid programs that might just not have the "name" which isn't everything to begin with.

PA school is very different than med school, and it's a GREAT option if you want the flexibility, and I understand completely where you're coming from on this topic. The depth of your education will be greatly different though, and while you don't mind not being top dog so-to-speak, if you go OBGYN as a PA, you won't be doing any surgeries yourself - you'd be assisting as if you were a permanent resident in a way. The more complicated cases will go to the physician 9/10 times. What you get in flexibility, you lose in depth of knowledge/skill/foundation/decision making. Your hours will be roughly the same, your call may be similar or lighter but not significantly in many cases, but overall work-life will be no different otherwise.

Some of my PA friends regret doing PA just as some of my DO and MD friends regret going to med school. I have also had a handful of PAs in my medical school class and know others who did the same but are practicing now, as well as others looking to enter med school.

I would not go off the notion that the flexibility is always worth it because even as a PA, there will be things you hate, things you love, things you suck at, and things you're great at. At some point, you're likely going to want to be in 1 field and stay there. As a DO, or MD, we just have to decide sooner. If we want another field, that's when we usually have to do a fellowship or another residency, or work in something that overlaps heavily (and usually not in a city or academic center in these cases). Also keep in mind that what you observed as a pre-med is very different than how you may feel doing the work. There were rotations I hated that I thought I'd want to go into, and vice versa.

If I were you, I'd create a detailed pros/cons, and put weight on the most important aspects. Consider your long term goals, current age/situation, etc, and then go from there.

There is way too much that goes into this decision than we can help with regarding the info provided. We'd need more info if we're going to help.

One thing of note, though... you are currently accepted to med school to start this summer. If you give up those spots, you're less likely to get into those places again if you choose to reapply later. And by starting this summer, you'll graduate 2024. Pre-reqs for PA school are different, and you stated you need more hours. You're looking at 1+ year to complete the hours and additional coursework, plus an app year, +2.5-3 years of school, graduating slightly later than you'd graduate medical school at this point. The only difference is going to be residency.

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[Mr.Smile12]

This is a real bad time to get cold feet. Did you not see physician assistants working when you shadowed in hospitals and clinics? I also will say not everything you believe in the forums by other applicants is necessarily true. The unified match will also impart changes.

I also will state the obvious: how well you match depends mostly on you, not what degree you earn. You don't want to spend 4 years in DO school only to wind up in a specialty you don't like... well, that happens for MD students a lot too.

There are many professional organizations of DO's in specialties that you can search for online.

As for PA requirements, you're going to need much more clinical experience, and PA programs also are very aware they don't want people who treat their career path as second fiddle to medicine or as an alternative.

@MusicDOc124 has the comprehensive response I couldn't type up fast enough.

 

[MusicDOc124]

Thank you I really appreciate your input. I just heard about the pass/fail change as well for the USMLE. Do you think this changes getting residencies even more now? It just looks like it would all be up to prestige of the school at this point (which seems pretty stupid since I know people who went to state schools for MD cause it was cheaper). Also what information would you need from me to advise me better? Like school attended, extra curriculars, life circumstances, etc.?
My pre-health office told me since I am no longer in college they don’t have to advise me anymore.

Short term and long term goals, experience in general and in healthcare, life situation, preference, what your gut is telling you.

 

[MusicDOc124]

Re: "Do you think this changes getting residencies even more now? It just looks like it would all be up to prestige of the school at this point (which seems pretty stupid since I know people who went to state schools for MD cause it was cheaper)."

I'm not too sure TBH. I suspect it won't change much for DO compared to say "low" or "mid" tier MD schools. There will be more weight placed on Step 2 which will still be scored. I simply feel Step 2 will be the "new" step 1 for determination. I think there will be more emphasis on research, evaluations, and away rotations.

 

[MusicDOc124]

So I am in my early twenties and just finished college. I think my long term goal is just to be able to do something I love no matter how long it takes to get there. My gut is telling me to reapply. I have a 3.9 from a top 5 public university so I have been able to perform in very competitive circumstances. I under performed on the MCAT but I thought a 3.9 coming from a top 30 school would outweigh my MCAT score. I was scoring 510s and got a 506 on the real thing. Super disappointed but decided to apply anyway. I supported myself through college and was working two jobs and taking care of my aunt (who has stage 4 lymphoma) while I was studying for the MCAT. One of the reasons I got my CNA was so I could help my family out by taking care of her better.
i just quit my full time job, paid for an MCAT course and will be doing nothing put MCAT for 3 and a half months. I am thinking if I flub the MCAT again. I will start working full time as a CNA, take the GRE (after studying), and apply for PA. I am young so I have time and I am currently living at home so I don’t have to pay for rent .

Also I would like to go to medical school in the south to keep up with my aunts health and my cousins declining health. My options I have currently are all on the west coast and Midwest ( I turned down the southern DO schools before I knew their health was that bad).Honestly I planned so much when applying to medical school and only applied to MD programs with 509 MCATs or below.

You have a lot of things going against you right now, and I see a series of not well-thought-out decisions.

You're in a spot right now with multiple DO acceptance. You have no MD acceptances, and don't have the coursework for PA, nor the hours.

The idea of not taking the acceptances, retaking the MCAT at a 506, and reapplying will leave you DOA at a multitude of schools, and you'll be at a disadvantage for being a reapplicant. Working as a CNA and retaking the MCAT at your current situation will not stand out enough for a large enough improvement to warrant a difference in what happens on re-application, except you'd unlikely be accepted at the same schools again, and no guarantee of getting interviews. It's been a while for me, but I believe AMCAS/AACOMAS ask if you've matriculated before, but maybe it is accepted? Either way, still not good.


"just to be able to do something I love no matter how long it takes to get there" and "I am thinking if I flub the MCAT again. I will start working full time as a CNA, take the GRE (after studying), and apply for PA"

These two lines tell me you do NOT want to be a PA.

With that said, you have 4 acceptances in hand. You'd be digging a relative career-grave by declining them simply to reapply with a minimally different app.

 

[DexterMorganSK]

Thanks for the honesty. I am just scared with how uncertain everything is with DO especially since I had no way of knowing the USMLE pass/fail would be occurring. I’ll take all of these thoughts into consideration.

I'm not an Adcom, but the way you're feeling toward the DO future is understandable.
Retaking the MCAT is a good decision; in the hope of getting an MD admission.
As far as PA vs MD/DO is concerned, you can only know this through shadowing (not just talking to friends in either field). Shadow different/multiple PAs. Good luck!

 

[MusicDOc124]

@DexterMorganSK Thanks. I just feel like I messed up everything honestly. And I just tried so hard even though people on this blog might think that I did not. I really truly tried to plan everything out to the best of my ability. i had no idea it would turn out like this. And I don’t think a lot of other people predicted this either

It's been a serious discussion for at least the last year, with talk even prior to that. Over the course of the last year, it's been updated numerous times that this was going to the board with timelines for the discussion. It just happens that it was announced today, but many already expected it, and the rest latest expected to hear something soon.

I wouldn't make a big deal out of it. There will not be much difference in DO applicants compared to MD applicants from the "lower" and "middle" tier schools. And with your MCAT and no responses from MDs as of yet this year, then I wouldn't expect all that much change for next year.

As you stated indirectly, you dont want to be a PA. You have an opportunity to become a physician right now. Giving that up means you might not even end up in medicine at all.

 

[MusicDOc124]

I take responsibility for that. But also I don’t spend a ton of time on here and it seems like this decision shocked a lot of people. Also I have had 3 interviews from MD programs. I asked feedback from the one waitlist I received and they told me I need to improve MCAT and that my interview was fine. I don’t see the harm in seeing if I can get my MCAT up high enough. And I won’t be working or going to school so I will be dedicating all my time to that. I’ll probably hold onto one DO acceptance since I agree it would be stupid to throw away at this point. I just don’t see what’s so wrong with trying. Especially with the news from today. My class will be the first class to deal with the repercussions of this decision and no one knows how this will play out. So I just want to give myself a fighting chance.

The only people worried are of course going to flock to forums. Many I know are not worried.

What do you mean “hold onto one DO acceptance?”

 

[Mr.Smile12]

I take responsibility for that. But also I don’t spend a ton of time on here and it seems like this decision shocked a lot of people. Also I have had 3 interviews from MD programs. I asked feedback from the one waitlist I received and they told me I need to improve MCAT and that my interview was fine. I don’t see the harm in seeing if I can get my MCAT up high enough. And I won’t be working or going to school so I will be dedicating all my time to that. I’ll probably hold onto one DO acceptance since I agree it would be stupid to throw away at this point. I just don’t see what’s so wrong with trying. Especially with the news from today. My class will be the first class to deal with the repercussions of this decision and no one knows how this will play out. So I just want to give myself a fighting chance.

So you'd rather go PA as long as you have DO offers, but if you get an MD offer from your waitlist, you'll stay in medicine and this discussion becomes moot. Is this an accurate summary?

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[MusicDOc124]

I asked feedback from the one waitlist I received and they told me I need to improve MCAT and that my interview was fine. I don’t see the harm in seeing if I can get my MCAT up high enough. And I won’t be working or going to school so I will be dedicating all my time to that.

Also, this may be true - but someone who applies with the higher MCAT and otherwise same application would concern me - noted per your last sentence quoted here that you would only be studying for the MCAT, no school, no work, etc. The harm is that you don't get in and you lost your seat for DO while also not prepared for PA. If you're truly that unsure, then you should let the DO acceptances go and pursue both the MCAT again and the GRE - WHILE in school completing the PA school pre-reqs that you dont already have AND WHILE working as a CNA to get the healthcare experience hours up. This will prep you for both, give you added experience to also signify a change in your application beyond only a chance in MCAT.

And per my last comment asking about "holding onto one DO acceptance?” - I was asking this because the only way to "hold onto the acceptance" beyond this current cycle is for a deferment - and without military service, a scholarship along the lines of Fulbright/Rhodes, or personal or family illness, you most likely won't get a deferral (especially to re-apply, which would lead to rescinding your acceptance even if granted the deferral), and if you don't intend to matriculate this year, holding onto the acceptance just puts others at disadvantages such as paying a deposit elsewhere to get off the waitlist here later, someone down the line getting in as school is about to start with a last minute move, or even starting after school started for those already in (this happened in my class, someone joined us 1 week into school and thus was already playing catch-up), etc. This last part is personal opinion, but it's a kind of a crappy thing to do if you really don't want to go.

 

[MusicDOc124]

I mean I am not trying to do a crappy thing. I am holding onto the acceptance because I want to be in my right state of mind when I make the decision not to go DO. I am going to wait a week or so before I decide what to do since I am still upset by the Pass/Fail and do not want to act irrationally. I also need to weigh the pros and cons of DO now with this new information and see if new material will be released about how they will judge people for residencies now that the USMLE is gone. You have a valid point with me needing to do something other than changing my MCAT so I will probably try to find work as a CNA soon. I think taking the MCAT and GRE together would be bad since it would result in me scoring lower on both. I also checked and I only need two more classes for the PA requirements.

if you look at the NRMP data every year, it tells you exactly what they look at... every year. It’s about 20 different factors. Step 1 is only 1. While it was among the most important, yes that will shift.

mind you, NBME isn’t going to make a statement. It’s not up to them. It’s up to program directors. USMLE isn’t going away. And ONLY step 1 will be P/F. Step 2 is still numerical.

no one is all of the sudden going to not look at everything else they already did. Step 2 will just somewhat replace step 1, letters of rec will be more important, as well clinical and preclinical grades, as well as research, as well as dedication to a field... all of this sounds familiar though..... because it’s all the same stuff what was considered already.

 

[Mr.Smile12]

I assure you that plenty of residency directors will have to adjust too. What you need to know is how well a school does to prepare students for the match and for a career in medicine. The other concerns you'll share with all medical school students, faculty, and student services folks and will not be that different for MD programs, as far as I know.

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