PA lifestyle?

[jbailey]

I'm tired of seeing people say "just go to med school." Just because you regret your life decisions doesn't mean others will.

Exactly. It's incredible how many times I've seen "Oh, you're younger than 27? Go to med school" on here. What if they don't want to be in school/residency for 7+ years before they practicing? What if they like the lateral mobility aspect of the PA profession?

 

I'd like to think the reason people choose to become a PA over a doctor is not merely due to age, family constraints, mortgages, or sick relatives. I mean, those are definitely reasons why someone would choose the shorter school length, but they are not the only reasons. The practicing PAs I know seem very happy with their decision to go to PA school, and they graduated from programs in their 20s with none of the complications listed above.

[jbird]

Just because someone offers advice to go to med school doesn't mean they are unhappy with their own decision. I think many, not all, young people that choose pa over med school do not think long term. I know I didn't think about life in my 30s when I was 21.

 

Everyone needs to make their own decision but the advice given by many here is coming from experience. There seem to be a lot of benefits that will come later in life for giving up an extra 5 years in your 20s. I suspect a lot of mid career PAs that suggest going to med school are extremely happy as a PA but have the maturity and life experience to realize being a doctor would provide many of the same benefits with more pay, respect, etc.

[PACdan]

Definitive PA vs. Medical School Decision Tree

 

                                     

                                                        yes >>>> Go to medical school.

"I identify strongly with this video" 

                                                        no >>>>> PA or med school.

 

 

[Monte]

Jbird, advice is one thing.. The guy came to this post to say "Go to med school." That's the kind of thing that isn't helpful. I've struggled with med school versus PA school for the past few years, and I certainly do agree with what you have to say.

[BruceBanner]

Med school is a terrible financial decision unless you have private funding (mom and dad) or you somehow get a large chunk of it paid for through scholarships or some other financial windfall. 

 

Think about the money. Not just what you will make, but what you will owe. That is what no one seems to consider when weighing out such a massive decision as being a PA or a MD/DO.

 

"Yeah, but I'll make a lot as a doc..."

 

Will you? When you're 35-40 and have a wife (or husband) and 3 kids and a colossal mortgage because you 'make so much'? Oh and don't forget the interest on those loans that were deferred for 4-5 years of residency.

 

Don't get me wrong, plenty of docs do fine. However, the good old days are gone and just about every younger physician I've known has said there aren't any intrinsic benefits to being a doc over a PA, unless you just cannot see yourself being anything but a doc. It also kind of depends on where your interests are. For FP or IM?? Man, be a PA. You'll be doing almost identical day-to-day work once you get experienced. If you think surgery, radiology, ophthalmology, etc is for you, then yes there is a big difference.

 

Another thing to consider is your career laterality. PAs can change specialties but it usually has to be peripherally related to what you have already done. Of course docs cannot, BUT simply having "MD" after your name opens up numerous non-clinical business opportunities that PAs don't have. Medical director, consulting of various forms, authorship, pharma, venture capital, etc.  

 

One final thought is that there is HUGE variability in terms of PA lifestyle, compensation, and working conditions. You can be totally autonomous or a glorified scut slave. You can make $60k all the way up to $150k+, in the extremes. You can have a cozy office job with no call or weekends or a hospital job with no predictability whatsoever. It is "what you make of it" in a sense, but there is sacrifice involved, usually with where you live, what you make, or what kind of working conditions you have. The old folksy adage is that you can pick two, and I think it's pretty reliable.

 

Personally, I've never regretted not going to med school for 1 second. And I had both offers on the table.

[Monte]

Med school is a terrible financial decision unless you have private funding (mom and dad) or you somehow get a large chunk of it paid for through scholarships or some other financial windfall.

 

Think about the money. Not just what you will make, but what you will owe. That is what no one seems to consider when weighing out such a massive decision as being a PA or a MD/DO.

 

"Yeah, but I'll make a lot as a doc..."

 

Will you? When you're 35-40 and have a wife (or husband) and 3 kids and a colossal mortgage because you 'make so much'? Oh and don't forget the interest on those loans that were deferred for 4-5 years of residency.

 

Don't get me wrong, plenty of docs do fine. However, the good old days are gone and just about every younger physician I've known has said there aren't any intrinsic benefits to being a doc over a PA, unless you just cannot see yourself being anything but a doc. It also kind of depends on where your interests are. For FP or IM?? Man, be a PA. You'll be doing almost identical day-to-day work once you get experienced. If you think surgery, radiology, ophthalmology, etc is for you, then yes there is a big difference.

 

Another thing to consider is your career laterality. PAs can change specialties but it usually has to be peripherally related to what you have already done. Of course docs cannot, BUT simply having "MD" after your name opens up numerous non-clinical business opportunities that PAs don't have. Medical director, consulting of various forms, authorship, pharma, venture capital, etc.

 

One final thought is that there is HUGE variability in terms of PA lifestyle, compensation, and working conditions. You can be totally autonomous or a glorified scut slave. You can make $60k all the way up to $150k+, in the extremes. You can have a cozy office job with no call or weekends or a hospital job with no predictability whatsoever. It is "what you make of it" in a sense, but there is sacrifice involved, usually with where you live, what you make, or what kind of working conditions you have. The old folksy adage is that you can pick two, and I think it's pretty reliable.

 

Personally, I've never regretted not going to med school for 1 second. And I had both offers on the table.

Well said! Wish there was more of this around here. In my case.. I've been raised by a single mom on disability. I would solely be taking out loans, especially just for living. I want the ability to start a life and family without that overbearing debt. I like what being a PA has to offer and I can't wait to become one.

[EMEDPA]

FP docs have lots of options for "lateral mobility". consider their options(most of these can be done with no additional training or a 1 weekend course):

traditional practice

hospitalist

wt loss clinic

occ med clinic

urgent care clinic

cosmetic derm

ER coverage

OB coverage

peds coverage

stress tests

scopes of all kinds

vasectomies

first assist general surgeons

etc.

 

This is the way to go. it's one of the easier residencies and the options are limitless. work as little or as much as you want. always be in demand.

med school debt doesn't have to be terrible if planned for well. I know lots of docs who attended state schools and ended up with less than 100k loans. look at the TX med schools. in state tuition is dirt cheap. ditto schoolls in the midwest, etc. or go to medschool paid for by NHSC, the military, the federal prisons, etc

Lateral mobility for PAs is gradually going away. 20 years from now it will probably be essentially gone and we will have to do a specialty internship and take a specialty specific test.this is the natural progression of a medical profession. it happened to the docs, it will happen to us. If you decide to be a PA stay ahead of the curve. do a residency, take a CAQ exam, get a doctorate. this sets you apart from other PAs and puts you on equal footing with the DNPs (at least in the mind of some HR folks who only understand highest degree earned).

[Boatswain2PA]

Med school is a terrible financial decision unless you have private funding (mom and dad) or you somehow get a large chunk of it paid for through scholarships or some other financial windfall. 

 

Think about the money. Not just what you will make, but what you will owe. That is what no one seems to consider when weighing out such a massive decision as being a PA or a MD/DO.

 

"Yeah, but I'll make a lot as a doc..."

 

Will you? When you're 35-40 and have a wife (or husband) and 3 kids and a colossal mortgage because you 'make so much'? Oh and don't forget the interest on those loans that were deferred for 4-5 years of residency.

 

Don't get me wrong, plenty of docs do fine. However, the good old days are gone and just about every younger physician I've known has said there aren't any intrinsic benefits to being a doc over a PA, unless you just cannot see yourself being anything but a doc. It also kind of depends on where your interests are. For FP or IM?? Man, be a PA. You'll be doing almost identical day-to-day work once you get experienced. If you think surgery, radiology, ophthalmology, etc is for you, then yes there is a big difference.

 

Another thing to consider is your career laterality. PAs can change specialties but it usually has to be peripherally related to what you have already done. Of course docs cannot, BUT simply having "MD" after your name opens up numerous non-clinical business opportunities that PAs don't have. Medical director, consulting of various forms, authorship, pharma, venture capital, etc.  

 

One final thought is that there is HUGE variability in terms of PA lifestyle, compensation, and working conditions. You can be totally autonomous or a glorified scut slave. You can make $60k all the way up to $150k+, in the extremes. You can have a cozy office job with no call or weekends or a hospital job with no predictability whatsoever. It is "what you make of it" in a sense, but there is sacrifice involved, usually with where you live, what you make, or what kind of working conditions you have. The old folksy adage is that you can pick two, and I think it's pretty reliable.

 

Personally, I've never regretted not going to med school for 1 second. And I had both offers on the table.

 

Finish PA school at 25 with $75-$150,000 in debt, start making $80-$110K a year, with a glass ceiling over your head for the rest of your career,

 

or

 

Finish residency at 30 with $100-$250K in debt, start making $250-$400K a year, with no glass ceiling. 

 

The latter one is a much better bet financially for young people.

 

And I agree with EMED.  Laterality will be gone for folks of this age before they retire. 

[jbailey]

What "glass ceiling" are you talking about? And you definitely inflated the average salary of a physician. And remember that medical school debt will also go way up due to interest during residency. I think your numbers overall were very generous toward physicians. And any guess about the demise of lateral mobility is just that: a guess.

[EMEDPA]

What "glass ceiling" are you talking about? And you definitely inflated the average salary of a physician. And remember that medical school debt will also go way up due to interest during residency. I think your numbers overall were very generous toward physicians. And any guess about the demise of lateral mobility is just that: a guess.

glass ceilings for PAs: scope of practice and salary. You will never see a pa doing a CABG as primary surgeon and making 750k/yr for doing so.

It is not difficult to make 200k as a physician in almost any specialty and 300k+ in things like EM, anesthesiology, derm, etc is not difficult. Making 1/2 that as a PA working far more hours is far more difficult. 110k is around the 95th percentile for PA salaries. most make 75-90k. I know specialty PAs making close to 150k, but they are exceptions to the rule.

Lateral mobility is already going away. To be credentialed to do a procedure TODAY you have to prove you have done it before. Outside of a residency, most PAs can not develop a significant procedure log for advanced procedures. Most physicians today don't want to teach. If a PA can't do something, the doc does it themselves. If I wanted to do CT surgery, for example I would have to prove I could harvest saphenous vein and do endoscopic radial artery harvesting. I can't do those. very few docs would want to teach me to do that and those that would probably would want me to take a 50% salary cut from my current job and work 80 hr weeks. Many of the new grad "we will train" jobs are essentially scut mills. sure, you learn your specialty but you burn out in less than 2 years. I would have to do a residency to get the skills without being abused. Lateral mobility to primary care will likely always exist, but between specialties(unless closely related like GI to peds GI) is becoming more difficult every year.

[LT_Oneal_PAC]

I'm tired of seeing people say "just go to med school." Just because you regret your life decisions doesn't mean others will.

They shouldn't ask people's opinion if you don't want an honest answer

[PACdan]

http://www.anderson.ucla.edu/faculty/keith.chen/papers/GenderNPV_WorkingPaper.pdf

 

Females entering primary care are better off becoming a PA than a physician, from a purely financial perspective. Male primary care PAs aren't too far behind male primary care physicians. Every other field, becoming a physician will ultimately earn you much more over a career.

 

I think for those that KNOW they only want to work in a primary care setting, an argument can be made for PA school, based on total career earnings (minus costs) vs. physician.

 

At least according to the MIT and Harvard trained PhD mathematicians and economists...

[LT_Oneal_PAC]

FP docs have lots of options for "lateral mobility". consider their options(most of these can be done with no additional training or a 1 weekend course):

traditional practice

hospitalist

wt loss clinic

occ med clinic

urgent care clinic

cosmetic derm

ER coverage

OB coverage

peds coverage

stress tests

scopes of all kinds

vasectomies

first assist general surgeons

etc.

 

This is the way to go. it's one of the easier residencies and the options are limitless. work as little or as much as you want. always be in demand.

med school debt doesn't have to be terrible if planned for well. I know lots of docs who attended state schools and ended up with less than 100k loans. look at the TX med schools. in state tuition is dirt cheap. ditto schoolls in the midwest, etc. or go to medschool paid for by NHSC, the military, the federal prisons, etc

Lateral mobility for PAs is gradually going away. 20 years from now it will probably be essentially gone and we will have to do a specialty internship and take a specialty specific test.this is the natural progression of a medical profession. it happened to the docs, it will happen to us. If you decide to be a PA stay ahead of the curve. do a residency, take a CAQ exam, get a doctorate. this sets you apart from other PAs and puts you on equal footing with the DNPs (at least in the mind of some HR folks who only understand highest degree earned).

My hometown tiny hospital will pay all of the med school loans off for a FP or IM doc, plus a hefty sign on bonus.

[jbailey]

I don't think anyone disagrees that most physicians will make more money in the long run. But I'd also like to enjoy the money I do make while I'm young and free from the responsibilities of a family with children. Also, 110k being the 95th percentile seems low...Just a Google search reveals that the top 10% make over 120k, but that may be misinformation. Correct me if I'm wrong.

 

Honestly, I just don't think it's right to have weathered/disgruntled PAs discouraging college students from entering their profession on this forum. Based on recent job satisfaction studies, these are the minority in the PA profession. People choose medical school and PA school for different reasons. I would hate to see good candidates for the profession turned away based on the opinions of a few.

[KMD16]

If you decide to be a PA stay ahead of the curve. do a residency, take a CAQ exam, get a doctorate. this sets you apart from other PAs and puts you on equal footing with the DNPs (at least in the mind of some HR folks who only understand highest degree earned).

Agreed.

[PACdan]

Honestly, I just don't think it's right to have weathered/disgruntled PAs discouraging college students from entering their profession on this forum. Based on recent job satisfaction studies, these are the minority in the PA profession. People choose medical school and PA school for different reasons. I would hate to see good candidates for the profession turned away based on the opinions of a few.

 

I don't think most of the experienced folk here are disgruntled, I think they're providing some counterpoints to consider.

 

For every pre-PA that has really researched the differences and future potential of PA vs. MD pathways, there are an equal number of people that get drawn in by the flashy Forbes "10 Best Jobs in America!" articles.

 

I hear in person and see online statements like "I want to spend more time with pts., so I'm going PA." or "I want to have a social/family life, PA makes more sense for me." These are falsehoods that keep circulating. Every career PA I know has to see pts. on the same time frame and scale as physicians. And depending on the field, work just as much or more.

 

The experienced folks here are just tempering these misconceptions with a dose of reality.

[KMD16]

^ True

[EMEDPA]

50% of all current PAs have been in the field 5 years or less due to the huge expansion in PA programs. There are almost 4x as many PA programs today as there were when I was in school in the early 90s. This demographic must bias the results if your avg PA is 23 yrs old and female. I would like to see a survey of folks who have been PAs for 10+ years with 50% men and 50% women. I think we would see a lot more dissatisfaction with the profession at that point as these folks have generally maxed out their potential and hit the glass ceiling HARD. most of the folks I know who have been PAs for 10+ years have seriously considered leaving the profession at some point, generally to go to med school to increase autonomy, scope of practice, respect, and earning potential. Many of the folks in my doctoral program are senior PAs attaining another degree so that they can leave clinical medicine and become researchers or full time academic faculty.

[Joelseff]

I don't think most of the experienced folk here are disgruntled, I think they're providing some counterpoints to consider.

 

For every pre-PA that has really researched the differences and future potential of PA vs. MD pathways, there are an equal number of people that get drawn in by the flashy Forbes "10 Best Jobs in America!" articles.

 

I hear in person and see online statements like "I want to spend more time with pts., so I'm going PA." or "I want to have a social/family life, PA makes more sense for me." These are falsehoods that keep circulating. Every career PA I know has to see pts. on the same time frame and scale as physicians. And depending on the field, work just as much or more.

 

The experienced folks here are just tempering these misconceptions with a dose of reality.

1000 times agree! I work in FP/HIV the past 3 years. I have my own panel of pts. I don't make much money. I work 10-12 hours a day if u include the time suck that is EMR charting and "hitting all the meaningful use measures" that I don't get paid for (my SP does) but still have to add the stupid metrics in my chart note... But I digress. My SP works 10-12 hour days as well but takes days off at will. He makes close to what I make, a little over, but also does speaking engagements all over the country and took a medical directorship at a community clinic where he only sees pts to 1/2 a day a week and makes extra coin. I laugh when I hear from pre-pas that they are pursuing PA to "have more time for family" or "have more time with pts." we only have 24 hours in a day and the work is the same so please pre PAs tell me where all this extra time is?

[db_pavnp]

I have a feeling that the 'no residency' aspect of PA/NP education goes a long way towards maintaining the work vs family relationship.

[ventana]

60 hours per week

 

not getting rich here.....

 

chasing paperwork is the bain of my existance..... I gave up on nonmeaningful use - not worth the 1.5-2% penalty for all the hoops to jump through.... much happier

[EMEDPA]

I have a feeling that the 'no residency' aspect of PA/NP education goes a long way towards maintaining the work vs family relationship.

for some specialties, specifically fp, the residency is not bad. first year(internship) can be tough, but for many 2nd and 3rd yr are not much more intensive than a regular job. I am frequently in the hospital more hrs/week than the senior residents I work with.

[Joelseff]

I have a feeling that the 'no residency' aspect of PA/NP education goes a long way towards maintaining the work vs family relationship.

Maybe? But the work continues for a PA beyond the 3 years that a residency would take for a MD/DO. I would have gladly done a residency with my current workload, if not a tad more, if I knew at the end if 3 years I would have my SP's (not to mention specialist docs) schedule. I think someone contemplating PA vs Doc needs to look beyond the training which is brief vs the lifestyle/workload/pay etc over the entire soon of the career. Just an overworked PA's humble opinion.

[Joelseff]

Ugh Span not soon... I hate autocorrect and tapatalk for having a broken edit function:angry:

[EMEDPA]

Maybe? But the work continues for a PA beyond the 3 years that a residency would take for a MD/DO. I would have gladly done a residency with my current workload, if not a tad more, if I knew at the end if 3 years I would have my SP's (not to mention specialist docs) schedule. I think someone contemplating PA vs Doc needs to look beyond the training which is brief vs the lifestyle/workload/pay etc over the entire soon of the career. Just an overworked PA's humble opinion.

agree. I work 180-240 hrs/mo for less than 1/2 the salary of my attendings who work 120-140 hrs/mo max.

who has more free time? who has a better lifestyle? who vacations in Italy for a month and who vacations 2 hrs from home for 4 days?

who goes to their kids school events and who is working during those events?