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Move out of state vs Medical school


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I live in southwestern PA and have been working in cardiothoracic and vascular surgery as well as EM for about a year now.  I'm starting to realize that the pay, benefits, and freedom are just not what I was hoping for.  Like, I just found out that there are no pay raises in my surgery position, only unrealistic incentive bonuses for quality patient care.  They also, more recently, took away paying for the PA's cellphones to cut costs.  I also realized that 2 to 3 weeks of vacation is not exactly reasonable in these specialties.  I look at the PA's with 10, 15, and 20 years of experience that I work with and think, "They are so knowledgeable, do I really want to have to deal with this when I have that much experience?" They can do a vessel to vessel anastomosis and a great groin breakdown in the vascular cases but they still act as medical transcriptionists for consults and new office visits? So I am stuck between moving to a much better state for PA's to feel more fairly compensated or just sucking it up and going to medical school.  Thoughts?  I am 24 by the way.

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Oof.  24.  Why did you choose PA in the first place?  I think that's a question you need to ask yourself.  If it was simply to get into the field earlier and without the length of med school, does the time and financial commitment that still exists for med school turn you away?  Or does it seem less of a negative now?

 

There is absolutely a ceiling for PAs, at least at this point, due to the nature of laws regarding our profession.  You can work for 20 years in your specialty and know just as much as the docs, but legally you might not be able to do all the same procedures and you definitely won't pull the same compensation no matter what state you are in.  That's just how it is.  If those are the things that will make you happy, then start looking at med school.

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I chose PA to get into medicine sooner without the length of schooling and debt.  I thought that PA's would handle the routine stuff basically on their own with little oversight but I am discovering that isn't true.  The financial component of medical school doesn't scare me as much as I wouldn't have to borrow much money at this point.  However, the time commitment is what bothers me.  I am much happier with my life not having to come home and study. 

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I chose PA to get into medicine sooner without the length of schooling and debt.  I thought that PA's would handle the routine stuff basically on their own with little oversight but I am discovering that isn't true.  The financial component of medical school doesn't scare me as much as I wouldn't have to borrow much money at this point.  However, the time commitment is what bothers me.  I am much happier with my life not having to come home and study. 

 

Then I guess the question is: would you rather know that you have a ceiling on your career and future or deal with more schooling?

 

If you think you might end up going the med school route in the future anyway, do it now while you're young.  Going back to school is much easier at 24 than it is later in life.  Perhaps you'd be interested in the PA/DO bridge program.

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Then I guess the question is: would you rather know that you have a ceiling on your career and future or deal with more schooling?

 

If you think you might end up going the med school route in the future anyway, do it now while you're young.  Going back to school is much easier at 24 than it is later in life.  Perhaps you'd be interested in the PA/DO bridge program.

 

 

I really think the ceiling is more played out than it needs to be, especially in non-operative fields. Yes, you will never have an MD and its almost impossible to be independent in certain fields such as surgery. But especially for PAs who go on to own their own practice, the sky is the limit. There is a family care PA here in Fayetteville who is awesome and makes almost twice as much as the average family practice physician. Yes, healthcare is bureaucratic and sometimes PAs get the short end of the stick. But if you are confident and caring enough to start your own practice, the sky is the limit. 

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I really think the ceiling is more played out than it needs to be, especially in non-operative fields. Yes, you will never have an MD and its almost impossible to be independent in certain fields such as surgery. But especially for PAs who go on to own their own practice, the sky is the limit. There is a family care PA here in Fayetteville who is awesome and makes almost twice as much as the average family practice physician. Yes, healthcare is bureaucratic and sometimes PAs get the short end of the stick. But if you are confident and caring enough to start your own practice, the sky is the limit. 

 

Owning a practice isn't in the cards for everyone.  If you take that out of the equation, then the ceiling exists.  Many of us (or maybe it's just me) chose PA because the idea of owning a practice has zero appeal.

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Owning a practice isn't in the cards for everyone.  If you take that out of the equation, then the ceiling exists.  Many of us (or maybe it's just me) chose PA because the idea of owning a practice has zero appeal.

 

 A ceiling exists in every profession for those who are unwilling to own their own business. Listen to the docs that work for  hospitals, they will tell you about ceilings and frustrations with healthcare reform. 

 

Also, depending on where PAs practice, the expectations will be totally different. For example, you go work the ER in "God know's where" North Carolina and you can be the OB, ER doc and Neonatologist all during one shift. And they will probably pay you 250,000 a year because no one else is crazy enough to work there.

 

But I get your point MT2PA, MD is the guaranteed way to assure yourself the "higher ceiling." However, while our profession may have a perceived ceiling, any particular PA can accomplish whatever they set their mind to. Thats how the PA profession has earned the role it has today. 

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I think comparing a PA to an attending is not looking at the whole story. You must also compare the PA to the medical student, the intern, the resident etc. There's a lot to be said about being a physician, but are you willing to go through medical school and a surgical residency? Is it worth the eighty hour weeks? Only you know the answer to that. For me it's a resounding hell no. 

Another thing to consider is practice environment. Maybe you'd get the professional respect you'd desire in a different specialty like FM, or a more rural setting where you are one of the few providers. It's quite impressive that you are a PA at such a young age so I would recommend you really examine the profession before exiting. However you are young enough that if MD is your dream you have the time to accomplish this. Best of luck to you.

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Guest ERCat

Sorry, but this seems a little rash to me! You are working your first job for a year. You can't judge the entire profession and how it will pan out for you based on your very limited experience. Also you say "I thought PAs have little oversight but have not found this to be the case." You are 24 and fresh out of school - of course you need oversight. That doesn't mean in a few years you won't be working lore independently. Maybe you just need to be in a different environment? I know plenty of PAs who don't feel that way about their jobs.

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I understand that I am still early in my career so I expect oversight.  I welcome it because it is a big part of how I am learning on the job.  But I see PA's with over a decade of experience still being forced to have an unnecessary amount of oversight.  I think about what is best for my future.  I want to be knowledgeable, have a comfortable lifestyle, and not have to have someone have to approve every simple thing I do like pull chest tubes, put in a chest tube, start anti-coagulation, discharge a patient, etc.  Do you think that all this oversight and micromanaging is just because of where I work?  Or do you think things would be better in a different region of the country?  Or would all the time climbing up the ladder to not have this oversight be better served completing medical school?

 

I do think that maybe a specialty change to something like FP or IM would allow me some more freedom in a few years but I also don't want to regret not going to medical school when I have a similar knowledge base as the physicians I work with.

 

We do have a PA who completed a residency in the city and she is treated the same as me for not much more pay (she's one year out of residency).  She chooses this area because of family purposes and I respect her wishes in that regard.

 

BTW, Thank you for all your replies! I never expected so many responses!

 

 

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Looks like you are fishing for a response directing you to medical school.

 

Sounds like you want to run the show. Got it; if you read the forums/ work as a PA long enough- you'll see that is a common thread.

 

You want absolute autonomy? Go on deployment with the military as a PA, work rural/remote, or go to medical school.

 

My opinion. Been a PA for 7 yr, ER now Trauma/crit care.

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Looks like you are fishing for a response directing you to medical school.

 

Sounds like you want to run the show. Got it; if you read the forums/ work as a PA long enough- you'll see that is a common thread.

 

You want absolute autonomy? Go on deployment with the military as a PA, work rural/remote, or go to medical school.

 

My opinion. Been a PA for 7 yr, ER now Trauma/crit care.

I think I do want to run the show.  Looks like I have some thinking to do...

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Just another thought- as someone who worked ER in Philly for 5 years and then moved away- yes, the pay and benefits are far better in other areas of the country.  Pennsylvania is, I believe, still one of the lowest average-salary states.

 

But I echo others- if you want to run the show, being a physician is the best way to go

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Just another thought- as someone who worked ER in Philly for 5 years and then moved away- yes, the pay and benefits are far better in other areas of the country.  Pennsylvania is, I believe, still one of the lowest average-salary states.

 

But I echo others- if you want to run the show, being a physician is the best way to go

 

Thanks.  I'm glad to know that there are better places!

 

How much better can it get for me?  Currently, I am $90,000 a year salaried for my CVTS position with $3/hr call that gives me $1,500 CME and 2 weeks vacation.  No real pay raises for that position and they increase vacation to 3 weeks at 2 years.  The ER position gives me $45/hr.  Do you think it is reasonable to expect much more somewhere else like NC?

 

I think I could feel fairly compensated with about 5-6 weeks vacation, $2,500 CME, and about $160,000 with only one of the two specialties I have now.  Unrealistic or realistic?  I see job postings for stuff like this but I always get the impression that there is a reason they pay that well whether your are forced to work 80 hour weeks or you have to work with some unruly doc.

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Thanks.  I'm glad to know that there are better places!

 

How much better can it get for me?  Currently, I am $90,000 a year salaried for my CVTS position with $3/hr call that gives me $1,500 CME and 2 weeks vacation.  No real pay raises for that position and they increase vacation to 3 weeks at 2 years.  The ER position gives me $45/hr.  Do you think it is reasonable to expect much more somewhere else like NC?

 

 

 

Wow, I make around the same salary as you in family medicine with more time off.

 

I couldn't imagine working with so few days off in surgery or the ER. You must be really burnt out.

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Wow, I make around the same salary as you in family medicine with more time off.

 

I couldn't imagine working with so few days off in surgery or the ER. You must be really burnt out.

 

Lol.  Thanks.  Surprisingly, I don't feel burnt out.  I really like what I'm doing.  I enjoy being in the OR, managing patients in the ICU, jumping to the floor, then getting to see patients in the ER with a totally separate group of people.  But, I do realize that I won't be able to keep this up forever so I will probably switch to just one specialty or the other in the future.

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  • 6 months later...

Congratulations. I assume by "starting this summer" you mean you were accepted to a program. This confirms what I have been saying ad nauseum on this forum. No undergraduate should be considering entry into PA school any more. Medical school is equally competitive for admissions, cost nearly the same as PA school and has vastly superior opportunities when you are finished. Unless and until the PA profession wins independent practice and abandons unnecessary reboarding, everyone should forget about the PA career and choose medical school or NP school. The PA profession will be extinct in ten years. 

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Congratulations. I assume by "starting this summer" you mean you were accepted to a program. This confirms what I have been saying ad nauseum on this forum. No undergraduate should be considering entry into PA school any more. Medical school is equally competitive for admissions, cost nearly the same as PA school and has vastly superior opportunities when you are finished. Unless and until the PA profession wins independent practice and abandons unnecessary reboarding, everyone should forget about the PA career and choose medical school or NP school. The PA profession will be extinct in ten years.

I'm wondering exactly how early someone has to get up to piss in your cherios every day.. obviously your burnt out. Go work at a convience store, work at Goodwill, something that makes you happy. Your apocalyptic drivel is old. Again, the sky is not falling.

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Thanks. I'm glad to know that there are better places!

 

How much better can it get for me? Currently, I am $90,000 a year salaried for my CVTS position with $3/hr call that gives me $1,500 CME and 2 weeks vacation. No real pay raises for that position and they increase vacation to 3 weeks at 2 years. The ER position gives me $45/hr. Do you think it is reasonable to expect much more somewhere else like NC?

 

I think I could feel fairly compensated with about 5-6 weeks vacation, $2,500 CME, and about $160,000 with only one of the two specialties I have now. Unrealistic or realistic? I see job postings for stuff like this but I always get the impression that there is a reason they pay that well whether your are forced to work 80 hour weeks or you have to work with some unruly doc.

California in ER is paying 75-100/hr

 

Sent from my SAMSUNG-SM-N920A using Tapatalk

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