Do you REALLY want to be a PA?

[myironlung]

I might upset a lot of people, and I respect many of you who contribute to this forum, but I do disagree with the OP. And just to set tone, I don't mean any disrespect to Rev Ronin, I just don't agree. So, firstly, whenever ANYBODY chooses a profession they do so with limited understanding of what it entails. One does not have to have already spent 10,000 hours as a CNA to know that they want to be a PA. The jobs are hardly related anyway. You are basically saying that I can't decide I want to be a PA unless I spend years in the industry and that just is inaccurate. Doctors decide they want to be doctors often when they are 18 years old! Would you argue that they can't do pre-med until they have been a CNA for 3 years so they have the right to say they KNOW they want to be a doctor? The very nature of choosing a profession inherently means you are not currently in that profession and therefore do not have extensive knowledge of what exactly it is like. Just because you assisted on one surgery does not give you any more right to decide you want to be a PA than somebody who is very passionate about the profession with very limited experience. Assisting on one surgery doesn't come close to describing what an actual PA does day in and day out. Yes, experience can help define a passion, and it can also squelch it, but nobody KNOWS for sure if they want to do something until they are actually doing that thing. So even you assisting one surgery doesn't give you any more credibility to make a decision about your career than anybody else.

 

Secondly, PART of the reason I am pursuing a career as a PA is because it is shorter (you may call it a short-cut, but that insinuates other things) than med school. Yes, technically med students as residents are "practicing medicine" but they certainly aren't supporting a family by doing it. My goal is to practice medicine, and wanting a shorter route to accomplish my goal so I can move on with my life and family is a reasonable desire.

 

Third, the PA profession is changing, as it should, with the changing need of of the health care industry. You all know the history of the PA profession, probably better than I, so I won't try to lecture you on it. However, the one thing worth pointing out is that the PA profession was created to fill a gap in the industry. If we want to remain relevant as practitioners then we need to be able to change and adapt to the changing need of the industry. Yes, PA's are still very much needed in Primary Care and underserved areas, I am not refuting that. But with the cost of health care, the aging population, the reforms, advancing technologies research and procedures -- they all lead to a new time for this industry, and PA's need to be there, in ALL reasonable areas to fill the gaps created. This means that 15,000 hrs as a CNA or EMT-B may not be the most relevant experience someone can gain for what they might be doing as a future PA. Maybe that time is better spent in a year long residency to learn surgical procedures. PA's can pat themselves on the back for what they once were as a profession, but if we want to remain a viable profession we must not get too attached to the way things were, and start embracing a vision of what the profession can become.

 

Your post communicates an air of elitism - that "you can't be in the club unless you pay the exact same dues I paid" kind of attitude. In my opinion, this is the kind of attitude that will quickly make this profession obsolete.

 

Starseed: asking about whether a GRE score is good enough CAN mean that somebody wants to get away with the least amount of effort possible, but to assume it on all those asking is really unfair. I took the GRE and did pretty well. I asked that question on this forum because I would rather spend my time doing other things to improve my chances of getting into school IF my score is good enough as is. It is a matter or prioritization. My knowing if my score is competitive I can check it off the list as one less thing I need to worry about so I can spend more time volunteering or shadowing. It is by no means an attitude of getting by with the least possible. It is an attitude of "where can I most improve."

 

While I truly appreciate everyone's posts and contributions to this forum as a whole, I am really kind of upset about the kind of attitude that this post portrays. It is elitism and protectionism. It comes off as being defensive which just looks kind of silly.

 

I completely disagree with rev ronin. I think that your response here was spot on excellent. Your check is in the mail.

[rev ronin]

Are you truly unaware of how many doctors have regrets about THEIR career choice? Doctors who wish they had done PA school vs. PAs who wish they had done med school...that's a stat I'd love to see compared.

Nope. I knew a guy pretty well once who was dissatisfied with the six-figure job he held at the pinnacle of an almost 20 year career in IT, so he decided to go back to school and become a PA... oh, wait, that's me. Doctors "trapped" in high-paying, high-pressure jobs because they chose at every step to continue along the path, from pre-med, to med school, to residency, investing more in it at each step of the way... no, gotta say, they get some sympathy from me, but their bed is of their own making. Getting intractably into debt is a bad idea in and of itself, but the only people who have to get into debt to practice medicine, either as PAs or MDs, are the ones for whom obligated service contracts won't work.

 

I honestly cannot see how you can reconcile these contradictions:

 

PA school is not a shortcut ----> but if you're YOUNG, do medical school instead.

Young folks just don't know what they want to do with their life ----> go to medical school instead.

 

Medical school is a long road that entails an avalanche of debt. It's not something you glibly recommend to people who, in the same breath, you say do not understand whether they really want to practice medicine.

If you think it's a contradiction, then you don't understand the point. The reason medical school+residency is seven years and PA school is at most three is that the typical med student hasn't got enough life experiences to practice medicine--which is NOT about simply knowing facts and being able to answer pimping questions on rounds at zero-dark-thirty. Medical school takes fresh smart kids and molds them into doctors. PA school takes seasoned adults and makes them medical providers. Either one is bad for people who don't belong in the practice of medicine.

 

I don't view PA school as some sort of "second best." In my opinion, it is a valid profession in and of itself, and it's not simply something you do because medical school was "too long." That's like saying schoolteachers are shortchanging themselves by not becoming college professors.

Nor do I view it as second best, although your point is somewhat undermined by the fact that most schoolteachers don't have the intellectual curiosity needed to succeed as professors, while I don't see any real difference in intellect between the docs and PAs I've known. The PAs tend to have better personalities and more diverse pathways into the profession. If anything PA is a second chance for those of us who missed the MD/DO train to practicing medicine in our youth.

[mktalon]

Rev, I am 31 years old and over those 31 years I have NEVER witnessed any correlation between somebody's age and their capacity to empathize (excluding very young children). I find young people that show incredible empathic listening skills, and adults who are jerks. Is there some kind of study that has been done that shows that young graduate students are socially retarded? That is quite the claim. I wish you would give something that might back that up because you are indicting a huge group of young people. Many of my friends are young graduate students and they don't show any less or more capacity to empathize than their lesser or more educated counterparts, whether older or not. I understand that you have gained value in living life, and are going to bring that with you and use it to make yourself a better PA. But that is YOU as an individual. Others have other things that they are uniquely bringing that will make them a better PA as well, just in a different way. Not everybody has to own a house, raise kids, and start a business in order to be a good PA. Your age is your asset. Use it as an asset. But don't enforce your asset as a requirement for others.

[rev ronin]

[...]4) Your entire first paragraph is completely irrelevent to success in PA school, so why should all of that be needed for acceptance into a PA program? I can tell you that those who did not make it through my program had these things going for them...

Because "getting through PA school" is not the same as "Being a good provider". You're arguing against the inclusion of a leg in a three-legged stool of HCE, scientific aptitude, and life experience, just because some of the people you know failed out of PA school that is primarily designed to test the second?

 

I feel like I'm in flatland here. The people who have it, understand the utility of life experience in patient care. Those who don't have it don't know what they lack, and to them what I'm saying makes no sense at all.

[mktalon]

With that said, I agree that there is a level of maturity that does need to be reached in order to practice medicine. However, there is a reason that adcoms make us go through those interviews. I am sure they are competent to weed out those that simply haven't reached this level of maturity.

[mktalon]

Nor do I view it as second best, although your point is somewhat undermined by the fact that most schoolteachers don't have the intellectual curiosity needed to succeed as professors, while I don't see any real difference in intellect between the docs and PAs I've known. The PAs tend to have better personalities and more diverse pathways into the profession. If anything PA is a second chance for those of us who missed the MD/DO train to practicing medicine in our youth.

 

Oh boy, now you just completely stirred the hornets nest. Your description of schoolteachers seems awfully close to those that criticize PA's as being drop out medschool students. You simply can't make those kinds of assumptions. Ever teacher has their own individual reason for wanting to become a schoolteacher. Maybe it is their intellectual curiosity that drives them to teach, to find better ways of teaching, or to stimulate the intellectual curiosity of young students. Point is, you are making far too many assumptions about a lot of different people, which, in of itself, is antithetical to empathy.

[noiseordinance]

I don't really know what to say. mktalon has already said it for me, in more detail, and more eloquently.

 

PS - I started reading this thread a couple hours ago. When I came back to see what had developed, I noticed it was gone. "Deleted," I thought. To me this was understandable: the assumptions made were completely closed-minded and fairly insulting. I was saddened to discover that it was placed as a sticky on a forum that has been otherwise quite helpful to me over the past three years.

[rev ronin]

Oh boy, now you just completely stirred the hornets nest. Your description of schoolteachers seems awfully close to those that criticize PA's as being drop out medschool students. You simply can't make those kinds of assumptions. Ever teacher has their own individual reason for wanting to become a schoolteacher. Maybe it is their intellectual curiosity that drives them to teach, to find better ways of teaching, or to stimulate the intellectual curiosity of young students. Point is, you are making far too many assumptions about a lot of different people, which, in of itself, is antithetical to empathy.

Let's be specific here: You believe that most K-12 schoolteachers have the intellectual curiosity needed to have earned a Ph.D. and published enough subsequent material to get tenure? Don't take "intellectual curiosity" out of the context of "needed to succeed as professors" and expect me to defend the out-of-context statement.

 

But of course, this is a bit afield from the thread.

 

(PS: And I know I don't have the intellectual curiosity to succeed as a college professor either, for whatever that's worth.)

Edited May 20, 2011 by rev ronin
Postscript

[andersenpa]

Understand that I've never said that young people can't get good HCE. But even if you start too early, it's hard to get 40 years of life experience packed into 25 years. Never underestimate the value of seeing people you know and love die and/or have kids of their own. Buying a house, starting a business, having hobbies, raising kids... there are so many life stages that you simply can't have gone through by you're 20's--certainly many that are incompatible with putting together the kind of portfolio that would lead to PA school admission.

 

One of the biggest values of PAs over MDs is the value of life lived before or in addition to medicine which brings empathy and authenticity to patient interactions. MDs, like young graduate students in general, have historically been socially retarded by staying isolated in a relatively homogenous environment. One of the valuable things about PAs is that it was historically OK for them to have lived life, made mistakes, and learned things on the way. A 25 year old PA or a 30 year old MD are both equally likely to be ill-equipped to connect on a human level with the patients who need that connection the most: the poor, the illiterate, the medically uneducated who place an unreasonable amount of faith in the advice they get from medical providers.

 

You can't put life in a book, take it in a pill, or watch it on a training video. Life comes with living it, and I firmly believe that the PAs who've earned the profession its reputation as better able to connect with patients than physicians did so on the basis of their own humanity and life experiences, not because they were trained better in school to do a patient interview or because they are allotted more time on the schedule to talk to patients.

 

Sounds like you're importing your personal experiences on the process in general.

Not everyone lives in the mold of life as you see it.

I have worked with young physicians my whole life. Every hospital I have worked at, pre and post PA-C, has been w/ residents. They are not socially retarded. Most are mature, inquisitive adults undergoing a strenuous and life-changing education.

 

Your notions are overwhelmingly narrow minded when it comes to those who fall outside your paradigm of which experience is "valuable"....

[andersenpa]

Oh boy how wrong you are. Many PAs, fresh out are solo providers at their practice with their SP only available by phone...if lucky.

 

A PA practicing solo fresh out of graduation is a major liability whether they entered PA w/ 10k hrs of experience or 2 wks of shadowing. Once again, overselling the value and place for HCE.

 

Besides I don't see "many" PAs in these settings right out of grad, your anecdotal observations notwithstanding.

[mktalon]

I don't really know what to say. mktalon has already said it for me, in more detail, and more eloquently.

 

PS - I started reading this thread a couple hours ago. When I came back to see what had developed, I noticed it was gone. "Deleted," I thought. To me this was understandable: the assumptions made were completely closed-minded and fairly insulting. I was saddened to discover that it was placed as a sticky on a forum that has been otherwise quite helpful to me over the past three years.

 

I think what saddens me is that the original post and those that agree with it really come off as treating the newcomers, to both the forum and the career, as "punk kids" that are just here to mess everything up. And many of those that agreed with it are huge contributors that I have learned a lot from. So I am saddened that this standoffish attitude is so widely celebrated as a "yeah stick it to 'em Rev, show those young punks a thing or two about what REAL PA's look like" victory. This is how I am interpreting this post, but I also understand that a lot gets lost in translation on forums. So I am not trying to judge anyone's character based on this post. It is saddening none-the-less. If this was not the way I should be interpreting this then please correct me, because I don't think we are or will be the only ones to interpret it this way. Was it made a sticky because the argument is relevant? Or because the person that made it a sticky agrees so enthusiastically with the OP?

[rev ronin]

I have worked with young physicians my whole life. Every hospital I have worked at, pre and post PA-C, has been w/ residents. They are not socially retarded. Most are mature, inquisitive adults undergoing a strenuous and life-changing education.

Perhaps I'm failing to choose the right terms, then. If you look at physicians, as a class, vs. college graduates, as a class, who gets married sooner? Who has kids sooner? Who buys houses sooner? Now, compare physicians to the average population. Every major life milestone is (on average and speaking in generalities) squeezed out until later in life for physicians, for whom learning the practice of medicine consumes essentially an entire decade.

 

When patients of their own age are having trouble with their teenagers, many physicians' kids are in grade school. What would you choose to call that disparity?

[rev ronin]

There are many reasons I chose PA over med school, and none of them had to do with my age. What about lateral mobility, for example?

This is a really good point, and one of the top 3 reasons I decided to NOT go to med school at my age. It's a absolutely valid point, articulately and politely made... but then, if you know enough to make it, you're not who I was writing the original post to.

[mktalon]

Let's be specific here: You believe that most K-12 schoolteachers have the intellectual curiosity needed to have earned a Ph.D. and published enough subsequent material to get tenure? Don't take "intellectual curiosity" out of the context of "needed to succeed as professors" and expect me to defend the out-of-context statement.

 

But of course, this is a bit afield from the thread.

 

Agreed this is getting a little beside the point. But to answer your question, I simply don't make any assumptions about the intellectual curiosity of anybody. It's not my place, nor do I know enough teachers so personally that I can assess their individual capacity for intellectual curiosity. You seem to want to wrap everyone up in nice neat compartments and in real life it just isn't that easy. I studied philosophy for my undergrad and I didn't end up going on to get my Ph.D. Does that mean that I don't have the intellectual capacity to be a professor? Or does it simply mean that my intellectual curiosity has motivated me in another direction outside of being a professor. Being a professor is just one way in which intellectual curiosity is expressed. College professors tend to be intellectually curious, but you fall into a logical fallacy by claiming that those that aren't professors are not equally intellectually curious.

[rev ronin]

College professors tend to be intellectually curious, but you fall into a logical fallacy by claiming that those that aren't professors are not equally intellectually curious.

You're not getting what I'm saying. You're treating intellectual curiosity as if I'd said schoolteachers don't have enough, rather than that they don't tend to have the right type. People can be curious, self-educating, and happy to teach others without feeling the desire to 1) spend years writing a dissertation on one topic or 2) write and publish enough peer-reviewed articles in the field to accrue the necessary academic credentials to attain tenure.

[mktalon]

Perhaps I'm failing to choose the right terms, then. If you look at physicians, as a class, vs. college graduates, as a class, who gets married sooner? Who has kids sooner? Who buys houses sooner? Now, compare physicians to the average population. Every major life milestone is (on average and speaking in generalities) squeezed out until later in life for physicians, for whom learning the practice of medicine consumes essentially an entire decade.

 

When patients of their own age are having trouble with their teenagers, many physicians' kids are in grade school. What would you choose to call that disparity?

 

I would simply call it a disparity. The word "retardation" carries many meanings with it. You may have meant it in a very literal way, meaning simply that the societal timeline of a med student is delayed. However, when the term "social retardation" is used, the vast majority of people will interpret that to mean that the individual is socially inept or severely lacks the ability to interact in appropriate ways.

[mktalon]

You're not getting what I'm saying. You're treating intellectual curiosity as if I'd said schoolteachers don't have enough, rather than that they don't tend to have the right type. People can be curious, self-educating, and happy to teach others without feeling the desire to 1) spend years writing a dissertation on one topic or 2) write and publish enough peer-reviewed articles in the field to accrue the necessary academic credentials to attain tenure.

 

Okay, if that's how you meant it then I'll concede the point.

[Hemegroup]

Rev, I am 31 years old and over those 31 years I have NEVER witnessed any correlation between somebody's age and their capacity to empathize (excluding very young children).

 

Wow .... really? I remember one of my 20-something classmates saying, "I would never give morphine for kidney stone pain". It wasn't the fact that he was 20-something, it was that he didn't have the experience of treating someone who is extremely diaphoretic to the point of being sopping wet and vomiting on the nurse due to their level of pain. In general, age brings wisdom. More specifically, experience brings wisdom. And experience tends to come with age.

 

rev knew what they were doing when starting this thread ... there are many 'kids' out there who think that PA is what they want, for various reasons, but the fact of the matter is that those same peeps have little to no idea what a crash course in medicine and being thrown into the fray of patient care brings with it. This is not a trivial position that pays well ... it's practicing medicine with every and all kinds of human beings and situations.

[mktalon]

Wow .... really? I remember one of my 20-something classmates saying, "I would never give morphine for kidney stone pain". It wasn't the fact that he was 20-something, it was that he didn't have the experience of treating someone who is extremely diaphoretic to the point of being sopping wet and vomiting on the nurse due to their level of pain. In general, age brings wisdom. More specifically, experience brings wisdom. And experience tends to come with age.

 

And if we were debating "wisdom" I might agree with you. However I was specifically responding the Rev's statement that younger people are not empathetic, which is why I used the word "empathy."

 

But to respond to your point, I am not arguing that experience, and the wisdom it brings, is not important in practicing medicine as a PA. I am simply arguing that we should perhaps consider the different types and ways in which future PA's can get that experience, especially in light of how the profession is and will continue to change.

[noiseordinance]

So by all means: those of you who have HCE, real-life experience, and the smarts to knock the science prerequisites out of the park, please come be PAs.

 

One thing that's not on this list is compassion, which cannot be taught, and may not come with age. Case in point, I have worked with plenty of seasoned healthcare professionals that I would not want providing my care. Conversely, while I am 30 now, I would be happy to have 20-year-old me as my PCP, assuming he had the education (which any dedicated person can acquire).

[Hemegroup]

And if we were debating "wisdom" I might agree with you. However I was specifically responding the Rev's statement that younger people are not empathetic, which is why I used the word "empathy."

 

But to respond to your point, I am not arguing that experience, and the wisdom it brings, is not important in practicing medicine as a PA. I am simply arguing that we should perhaps consider the different types and ways in which future PA's can get that experience, especially in light of how the profession is and will continue to change.

 

The fact that you don't understand the relationship between experience and empathy (which I thought I plainly detailed in example) is puzzling to me. Was that student empathetic? No. Was it due to a lack of experience? Likely. Did he have the wisdom necessary to have the empathy? No.

[noiseordinance]

Wow .... really? I remember one of my 20-something classmates saying, "I would never give morphine for kidney stone pain". It wasn't the fact that he was 20-something, it was that he didn't have the experience of treating someone who is extremely diaphoretic to the point of being sopping wet and vomiting on the nurse due to their level of pain. In general, age brings wisdom. More specifically, experience brings wisdom. And experience tends to come with age.

 

I think it's great that you and rev have had these types of experiences, and I wish we all could have them prior to PA school. Sadly, I'm not exposed to those scenarios on a day-to-day basis while I develop my healthcare experience, and I reckon most folks on here weren't / aren't either. Nevertheless, I don't need that type of experience to dedicate myself towards making the right choice to the best of my ability, paying attention to detail, knowing when a situation is out of my league, etc.

 

I do agree with a lot of what rev said at the beginning of this topic. But just because some of you old-schoolers think there should be age requirements for becoming a PA because IT WORKED FOR YOU doesn't make it necessary for others. In fact, it doesn't even make it worthy of being a sticky.

[Hemegroup]

I think it's great that you and rev have had these types of experiences, and I wish we all could have them prior to PA school. Sadly, I'm not exposed to those scenarios on a day-to-day basis while I develop my healthcare experience, and I reckon most folks on here weren't / aren't either. Nevertheless, I don't need that type of experience to dedicate myself towards making the right choice to the best of my ability, paying attention to detail, knowing when a situation is out of my league, etc.

 

I do agree with a lot of what rev said at the beginning of this topic. But just because some of you old-schoolers think there should be age requirements for becoming a PA because IT WORKED FOR YOU doesn't make it necessary for others. In fact, it doesn't even make it worthy of being a sticky.

 

It's not an age issue, with me, it's experience. The most you can get prior to PA school is optimum, that's the bottom line. It's probably the main reason behind so many patients requesting to be seen by me. I understand your eagerness, and I think it's great. But be careful not to let your ego get in the way, in any situation.

[marilynpac]

A PA practicing solo fresh out of graduation is a major liability whether they entered PA w/ 10k hrs of experience or 2 wks of shadowing. Once again, overselling the value and place for HCE.

 

Besides I don't see "many" PAs in these settings right out of grad, your anecdotal observations notwithstanding.

 

How often have you practiced in a rural area? I mean rural......

[mktalon]

The fact that you don't understand the relationship between experience and empathy (which I thought I plainly detailed in example) is puzzling to me. Was that student empathetic? No. Was it due to a lack of experience? Likely. Did he have the wisdom necessary to have the empathy? No.

 

I understand the relationship between empathy and experience. I just don't agree with where Rev seems to draw a hardfast line regarding the specific experience required to make a better PA. His examples were home ownership, starting a business, and raising a child. This is what I was responding to. I'll say it again, I do think experience is important. I am just challenging the way Rev seems to think is the ONLY way to get appropriate experience and the age at which he defines it to be valid.