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PA to DO in three years for cheap?? Please chime in.


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Good Evening All,

 I have been contemplating this for some time. LECOM has developed a 3 yr PA-->DO program. The pass rates and scores have been above the national average and the matches look pretty good. I am getting out of the Army soon. Ive been in for 8 yrs (only part as a PA) and will be 29-30 at the time of matriculation.

 

The question: I am eligible for 36 months of Post-911 GI bill that will cover about 80-90% of the cost of school plus living expense (about 1300$ monthly) as well as books. This is a veteran right and requires no additional service. My loans after school would be roughly 25K or less (dependent on savings). I have no debt now. I might be eligible for a grant that would cover the rest and essentially get a free doctorate. 

 

I never worked in the civilian world as a PA and have been 99% autonomous since day 1 out of school. I deployed within a couple months of arriving to my first PA assignment. I was in a role 1 hours away from the nearest provider. I have only worked an odd mixture of primary care with emergency medicine. Hard to explain this odd niche we fill. Fellow Army PAs can attest.

 

 Will I be un-happy as a PA in the civ world? If you were in my shoes, what would you do? I have all the pre-req for the school and got a 4.0 in PA school. I was a human bio major with all the med-school pre-reqs. All I would have to do is submit a packet to the medical school and hopefully get accepted. No MCAT, no classes.

 

The only specialities I would be interested in is E-Med, Anesthesiology or possibly internal medicine with the possibility to do a fellowship later on in critical care or infectious disease. These seem to be a mid-competitive specialty and should be pretty easy to match to.

 

It seems like as a PA working E-Med, you will be doing the same work for a 1/3rd  the pay and always having someone trying to critique your work. Also, I wouldnt mind working in academia when Im older and participating in case studies and research with some of the techniques, drugs and procedures I have seen and done by working alongside dozens of different NATO nations. I feel as a PA, my ideas may just get snuffed out.

 

What kind of salary and benefits could one expect with 6yrs experience? Looking for E-Med, Traum Surg, Neruosurg.

What will my scope of practice and daily hours look like? If PAs work significant less hours of work, I would be okay with the pay difference. Im assuming most work 40-50 alongside the docs. 

 

Thank you all for your time. I appreciate all responses. I enjoy what I do now and absolutely love medicine. I just dont want to roll around to 40 years old and look back at all those years and wished I would have just sucked it up for 3 years. 

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If I were your age I would do it.  Not that it would make me a better practitioner, but it would make my profession far more socially accepted and greatly increase opportunities. As a PA you will always be considered dumber than you really are, as a DO you will always be considered smarter than you really are.

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Good Evening All,

 I have been contemplating this for some time. LECOM has developed a 3 yr PA-->DO program. The pass rates and scores have been above the national average and the matches look pretty good. I am getting out of the Army soon. Ive been in for 8 yrs (only part as a PA) and will be 29-30 at the time of matriculation.

 

The question: I am eligible for 36 months of Post-911 GI bill that will cover about 80-90% of the cost of school plus living expense (about 1300$ monthly) as well as books. This is a veteran right and requires no additional service. My loans after school would be roughly 25K or less (dependent on savings). I have no debt now. I might be eligible for a grant that would cover the rest and essentially get a free doctorate. 

 

I never worked in the civilian world as a PA and have been 99% autonomous since day 1 out of school. I deployed within a couple months of arriving to my first PA assignment. I was in a role 1 hours away from the nearest provider. I have only worked an odd mixture of primary care with emergency medicine. Hard to explain this odd niche we fill. Fellow Army PAs can attest.

 

 Will I be un-happy as a PA in the civ world? If you were in my shoes, what would you do? I have all the pre-req for the school and got a 4.0 in PA school. I was a human bio major with all the med-school pre-reqs. All I would have to do is submit a packet to the medical school and hopefully get accepted. No MCAT, no classes.

 

The only specialities I would be interested in is E-Med, Anesthesiology or possibly internal medicine with the possibility to do a fellowship later on in critical care or infectious disease. These seem to be a mid-competitive specialty and should be pretty easy to match to.

 

It seems like as a PA working E-Med, you will be doing the same work for a 1/3rd  the pay and always having someone trying to critique your work. Also, I wouldnt mind working in academia when Im older and participating in case studies and research with some of the techniques, drugs and procedures I have seen and done by working alongside dozens of different NATO nations. I feel as a PA, my ideas may just get snuffed out.

 

What kind of salary and benefits could one expect with 6yrs experience? Looking for E-Med, Traum Surg, Neruosurg.

What will my scope of practice and daily hours look like? If PAs work significant less hours of work, I would be okay with the pay difference. Im assuming most work 40-50 alongside the docs. 

 

Thank you all for your time. I appreciate all responses. I enjoy what I do now and absolutely love medicine. I just dont want to roll around to 40 years old and look back at all those years and wished I would have just sucked it up for 3 years. 

The only thing I would caution you on is going in thinking you are going to get a specific residency. Two of the specialties that you mention are reasonably competitive. My personal opinion is that the LECOM grads are competitive for family practice but unproven for other specialties. Primadonna just started residency if I recall, and while I can't remember what residencies the first class went, looking at their webside 1/2 are designated primary care. The residency system in my opinion is tilted against DOs. The merger between AOA ACGME residency merger means the situation is more muddled. Potentially this opens up ACGME residencies, on the other hand AOA residencies that are in competitive specialties are now open to allopathic students. One of the questions you have to ask yourself is would you be OK with a residency outside the three you mentioned. 

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I would 100% do it. I actually know of an ex-air force PA who got out and went to osteopathic med school (Not LECOM) and matched into a family medicine residency. It wasn't his thing and so he opened a successful urgent care practice and moonlights in several ER's with full respect and autonomy from the boarded EM docs (all because of his EM military experience). I don't believe family medicine residency restricts you from being stuck there (especially with the experience you have). And a rural community would love you as you could probably "do it all" there.

 

This is a no-brainer to me.

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Dont do it.

Always need a contradictory opinion.

There was a reason for you becoming a PA. Is it still valid?

Are you on your own or do you have some family tagging along? If so, are they OK with you pursuing this?

It is more than 3 years you are sucking up. It is 6. 3 in school. 3 in residency, maybe 4. Your residency salary likely wont break 50k each year.

With your experience, you likely can land a position paying minimum 100k, x 6 years is at least 600k you have missed out on. Sure, you will be able to eclipse this later but will still have to make up this deficit including contributions to retirement accounts over those 6 years.

If you continue with your pattern of acheivement, you likely will end up with a residency of your choice. But will there be an opportunity where you want to be? I speak from my own anecdotal experience of working at a critical access hospital in the ED with much autonomy as a PA. Financially, my place does not have the funds to hire a group of physicians, it would break the bank.

Stay away from surgery. More likely you will not experience autonomy or independence there as a PA. You will in rural EDs and in primary care and IM clinics. So go where you wont be disappointed.

With your experience, you should be able to get 100k+. I can only say that because PA salaries can be hard to pin down. I make 165k, some admin and OT pay in there. I work 1600 hours per year, 11 twelve hour shifts per month. Your mileage may differ. This is obviously less than a physician makes. But I sincerely doubt I could have ever put together the grades and scores needed to get to that point. I just took a different path to practice medicine and that is that.

Consider a one year ED PA residency. One year at 50k filling in areas you didnt see in the military, may actually be able to get some of that stipend money from the GI Bill? But between that and military experience, you have about as close to the golden ticket as one gets.

Academia, research, all of that can look interesting until you get hip deep into it. Yeah, you need a doctorate. But could you use that GI Bill money for a Doctorate as a PA to get you where you want to be, at the same time earning more? You then become a big fish in our pond rather than another fish in the physician pond.

I hope you stay a PA. I realize there are PAs that become doctors. They have their motivations and reasons which are valid for their situations. But I also think there is opportunity as a PA and I think that opportunity will improve.

Good luck with your decision.

G Brothers PA-C

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^ sorry I disagree.

 

The OP will be getting free education literally. Would comes out with only $25K of total student loan vs 200-300+ K debt.

 

At 50K/ yr w/ $25k student loan debt. That's pretty nice. He'll still be able to pay his student loan while in training.

 

Very quickly. Let do the math. OP would loss 600k salary for the 6 yrs in school ( 3 yrs DO and 3 yrs residency). Let say, the OP did EM residency and became EP BC. ED doc starting salary is $350K/y. If the OP work smarter, he has the potential to make $600+/yr as ER doc.

 

So the $600k loss of income could be replenish in a yr or two post residency. A Huge gain here.

 

It will be a different story if say his student loan were 300-400k.

 

Just my 2c

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^ sorry I disagree. The OP will be getting free education literally. Would comes out with only $25K of total student loan vs 200-300+ K debt. At 50K/ yr w/ $25k student loan debt. That's pretty nice. He'll still be able to pay his student loan while in training. Very quickly. Let do the math. OP would loss 600k salary for the 6 yrs in school ( 3 yrs DO and 3 yrs residency). Let say, the OP did EM residency and became EP BC. ED doc starting salary is $350K/y. If the OP work smarter, he has the potential to make $600+/yr as ER doc. So the $600k loss of income could be replenish in a yr or two post residency. A Huge gain here. It will be a different story if say his student loan were 300-400k. Just my 2c

although I agree with your conclusions I disagree with your math. it is the rare ER doc who can make 600k/yr unless they work every day.

most make 225-350k or so with a reasonable workload.

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FYI in my class we had PA-DOs match no problem into allo academic anesthesia, IM/CC and rads. I expect to see some good matches for the 2015 class as well. I had extremely attractive IM options as well and chose my unopposed community FM program for different reasons--mostly because it "fit" and felt right. Never really worried about whether I would match--the harder part was to decide which program to rank #1. Ultimately I found out 5 days before rank lists were due that I was awarded NHSC loan repayment, and that sealed the deal for me to rank my local inpatient-heavy, procedure-heavy FM program first.

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although I agree with your conclusions I disagree with your math. it is the rare ER doc who can make 600k/yr unless they work every day.

most make 225-350k or so with a reasonable workload.

Agreed. 220-350k is the base w/ potential to earn $600k if you work smart ( pick up UC shift or extra shift on days off). There's no limitation on your salary as a doc vs PA.

 

 

 

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Agreed. 220-350k is the base w/ potential to earn $600k if you work smart ( pick up UC shift or extra shift on days off). There's no limitation on your salary as a doc vs PA.

if you are work 12-14 twelve hr shifts as a doc you probably don't want to do more than that unless you are in serious debt and there is an endpoint in sight( "I will work an extra shift/week for a year to pay off my student loans", etc). one of the reasons to go the doc route is to be able to work less and still make a good salary. I usually work 16-18 12s/mo. I would love to work 12 for more money and have a lot more free time. remember money isn't everything. thinking smart IS working less and enjoying life more...

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do it. As a MD there is no salary cap. you can open your own business, hire more MDs and endless PAs and earn billions a year. you do not want to look back an regret trying the md route. you can always quit md any time and return to your humble PA ways.

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do it. As a MD there is no salary cap. you can open your own business, hire more MDs and endless PAs and earn billions a year. you do not want to look back an regret trying the md route. you can always quit md any time and return to your humble PA ways.

 

You can open clinics/hospitals without being an MD.  Hell you dont even need a PA.  There's a reason why most hospitals and large clinics in this country are run by MBAs instead of PAs or doctors.  

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I agree with everybody, including the chorus of people saying it's a no-brainer AND the always-valuable contrary opinion from GB.

 

It comes down to what your goals are, what kind of medicine you want to practice, and how and where you want to practice it.

 

The reasons for being a PA and not an MD or DO can be tough to pin down sometimes, and/or hard to remember once we've been doing it a while. There are very good arguments to be made that practicing at the "top of your license" is good, and it's reasonable to think that practicing at the top of the hierarchy of licensed professions is better for the same reasons. However, you are a PA, and very likely a damn good one, and we shouldn't be so blithe about encouraging you to leave the profession.

 

The fact that you've always been a military PA and never a civilian one is definitely relevant, I think. Ideally, you'd talk with someone who made that jump a few years ago, and see what they have to say.

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You are young, move up. Maximize your potential for as long as you can. But ask yourself, do you want all of the risk and responsibility, or part of the risk and responsibility. Its different. If you dont want it all, the money wont make you like it, if you want more, practice limitations and less money will frustrate you. Funny enough, many of the ER docs I work with (about 60) are trying to figure what else they can do, to get out of medicine. Hands are tied, admin enforcing ridiculous rules, docs forced by their companies to take hits to maintain co. contracts. Its messy. Not just 10 hour then leave. As stated above, what is your goal?

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You are young, move up. Maximize your potential for as long as you can. But ask yourself, do you want all of the risk and responsibility, or part of the risk and responsibility. Its different. If you dont want it all, the money wont make you like it, if you want more, practice limitations and less money will frustrate you. Funny enough, many of the ER docs I work with (about 60) are trying to figure what else they can do, to get out of medicine. Hands are tied, admin enforcing ridiculous rules, docs forced by their companies to take hits to maintain co. contracts. Its messy. Not just 10 hour then leave. As stated above, what is your goal?

The physician side of the fence is not always greener, just ask them. There can be quite a bit of dissatisfaction in many careers in medicine, physicians are not immune to this. Much social change that we are just at the beginning of in this country that will affect healthcare and all who work in it.

GB PA-C

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I cant thank you all enough for your help. I will debate these points you have brought up. I absolutely love being a PA and medicine in general. I never really planned on going to medical school because of the financial burden and time away from being a clinician. The whole Post 9-11 GI bill has made me re-think it. LECOM shaved off 25% of time. Also the ability to be recognized world wide as an autonomous medical professional. I believe PAs have made leaps and bounds in the past decade and will continue to push their envelope.

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I cant thank you all enough for your help. I will debate these points you have brought up. I absolutely love being a PA and medicine in general. I never really planned on going to medical school because of the financial burden and time away from being a clinician. The whole Post 9-11 GI bill has made me re-think it. LECOM shaved off 25% of time. Also the ability to be recognized world wide as an autonomous medical professional. I believe PAs have made leaps and bounds in the past decade and will continue to push their envelope.

 

 

Even though your med school would be free, you are facing an enormous opportunity cost by choosing to not make PA income for minimum of 6 years and maximum of 10 years.  

 

In 10 years, I could see PAs completely taking over emergency medicine, IM, FP and CRNAs will continue their dominance of anesthesia.

 

The only MD specific career that justifies such a long opportunity cost is for specific medical fields that PAs/NPs have no chance of taking over -- for example high end surgical subspecialty.

 

So lets say you want to be an EM doc.  What's to say that when you are finally done with school and residency 7 years later that emergency rooms will choose to hire you over a PA?  It's not clear to me at all that emergency rooms still prefer MDs to PAs.  

 

I'm not saying you shouldnt do med school -- I'm just saying you need to consider the climate and job market you will be going into and the lost opportunity cost.  6 years of lost PA income is a lot of money you are choosing to forego.  And 6 years is the bare minimum if you want to do primary care.  EM or anesthesia would be 7 years, IM/critical care would be 9 years, general surgery would be 8 years, neurosurgery would be 10 years.

 

If you are going to med school to become a neurosurgeon, then it's a no brainer.  But choosing med school for FP, IM, EM, peds, anesthesia, doesnt give the return on investment that I would want.

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most em residencies are 3 yrs, some are 4, so one could be a residency trained/boarded er doc in 6 yrs.  at 250-350k/yr you would make up that lost 600k of pa income pretty quick.

ER PAs are nowhere close to taking over the specialty aside from in very rural or underserved (rural Alaska type)settings. 95% of ERs want residency trained/boarded ER docs and often won't even hire an FP doc with em experience anymore.

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Also, residencies pay around 55K a year and typically allow for moonlighting the final year of ER residency and could easily make up for the difference in PA pay with just a few shifts a month. The income loss would be similar to this:

6 years of medical school + res without salary of 100K/yr= 600K

Subtract pay and GI Bill living expense of 15K a year for 3 yrs and 55K a year for 3 yrs res = 210,000

 

600-210= 390K and then you could subtract the moonlight pa final year of at least 50K = 340K of loss of income (plus 6 great years of life!)

 

Im not to sure on the pay of ER BC Phys, but online it looks like 280-350k is the norm. Does this sound correct? If this is so, one could pay off the income loss in just a couple years. So before the age of 40 for me, I would break even.

 

Once again, however, the income difference is just a small part of it. I can live happily on 100-120K a year easily. Even what Im making now in the underpaid military isnt bad. A lot more than and trigger puller or line medic that is constantly in danger. 

 

The big benefit of my current situation is ZERO debt. Zero debt plus 100-120/yr is actually a comfortable income.

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Also, for anyone who has lived/worked in Alaska, how is the current job market? What is the pay and hours like compared to the lower 48? I find a lot of contrasting information online. I see anything from 3rd most PA friendly state to near the bottom. I also see on of the highest paid vs lowest.  I own a house in Alaska from one of my duty assignments there and have a lot of family in the area.

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