PA vs. MD

[Flexyahmind]

I know this post is probably going to annoy or get flamed by a bunch of people, so I apologize in advance. But I have to bring up this debate (and internal dilemma) here so I can get an objective opinion from actual PA's. I'm a paramedic who has pretty much completed pre-reqs for PA school and only need a few for med school. I would like to know why some PAs and PA students went the way they did rather than something like med school. Currently I'm just looking at how the time frame, cost, and stress med school will have an effect on my life. But I actually wrote out a pros and cons list and would like to hear others input (correct me if I'm wrong).

Pros:

PA - less time to licensing and practicing

- less money for school

- Some autonomy

- good money

- generally respected for their knowledge and opinion by their colleagues and pts.?

- less liability and paperwork?

- can move freely through fields of practice?

- hours are better than MDs

- more time for extracurricular activities (i.e. at home with family, travel, gym,

running a business, etc.)

 

MD - Complete autonomy

- Most respected in their field

- Most hands-on time with patients for procedures in respective fields (especially

surgical)

- In charge

- More knowledge and education

- Most job security (excluding malpractice)

- Can practice worldwide

- Really good pay

 

Cons:

PAs - Less respected for their knowledge in the grand scheme of medicine

- Less opportunity for being sought out to do presentations or seminars.

- Less respect from insurance and drug companies

- Less education and knowledge than an MD

- Less job security

- Capped salary

 

MDs - roughly 7-10yrs before practicing with full autonomy

- $200K+ for school

- ~80hrs/wk residency

- >50hrs/wk attending or practicing

- less time for extracurriculars (as previously mentioned)?

- A lot of liability and paperwork

- Lots of stress

I'm sure there's more I'm missing so if I could get some OBJECTIVE input and also corrections to anything listed please help me solve this dilemma that keeps weighing down on my conscience. I'm from California and would prefer to practice here, that's why I posted here.

 

Thank you in advance,

S

[Blessings!!]

It is a long never ending discussion. I believe you have said every thing in a nut shell. I would say do whatever is good for you, don't listen to me or some one else. Listen to your heart. Look at your circumstances, your priorities, your family. It looks like you want to be MD and you are trying to convince yourself for PA. Working as a PA is not limiting you to learn medicine. There are many PAs coming from medical back ground with doctorate degrees.

[EMEDPA]

good lists aside from pa "hours are better than md's" and "more time with family". most pa's I know work more than the docs they work with. in my group the avg pa works 160-180 hrs/mo and the avg doc works 120-140. the reason docs hire pa's is to work at the times and places they don't want to work. that means nights/weekends/holidays/early am rounds, late night discharges, etc.

our job is to allow THEM more free time with THEIR families.

also, except in the situation of clinic/practice ownership, paperwork and liability are the same for pa and md. a pa who owns a clinic has more paperwork hassles than an md who does not for example.

the respect thing can be a real downer until you find the right job. took me 5 yrs to find a job that respected pa's, with good autonomy and scope of practice.

if I was starting over from scratch today I would go D.O./MD

[marilynpac]

I second that...DO for me

[GREATMDPA]

I went to medical school in the carribbean and didn't get in residency so I'm in PA school right now. I have similar internal conflicts in that whether I should pursue residency after 1 or 2 years of practice as a PA or remain as a PA. I think it really depends on the kind of practice you want to do. I want to do primary care in underserved areas, whether as a PA or MD, and the way I understand, there is very little difference between MD and PA in underserved primary care settings.

 

Here are a few things you gotta consider: your age, type of practice you'd like, how much time you want to sacrifice for medicine before you can start having a life.

 

If I could start over, I would actually do PA first and work a few years to save up money and then go for MD/DO (if I really want to pursue medicine further). I heard some DO school is only 3 years if you're a PA. I wish I had known more about these professions back then 10 years ago. I knew about DO but I guess I didn't have a thorough understanding of their philosophy so I immediately wasn't interested. I just found out about PA profession last year after I didn't match in a residency, and my DO boss told me about it. So now you have an advantage that you have a good understanding about the profession.

 

Your age matters a lot. I'm 31 years old right now, and the important thing for me is to have a good life and enjoy it as much as possible. When I started medical school at the age of 21, I was very eager and energetic and all I had in mind was medicine. Medicine requires a great deal of stamina, and we tend to lose that stamina as we age.

[crieman]

I've been out of school for just over a year and have already met with a pre-med advisor. I really want to go back to school. It just depends on where you want to practice. In rural medicine there is no point to going back to school for MD/DO. There isn't enough difference to justify the time and money. Inpatient medicine is completely different and this is why I want to go back to school. Sure, I work less hours than the MDs but I make a 3rd of the money and do 90% of what they do. The difference where I'm at is the procedures. The other thing that really sucks is that we routinely have the diagnosis made by the time the docs see them and they get 100% of the credit. Very aggravating.

[marilynpac]

Your thread tells me you don't know everything about rural medicine. Many of the hospitals in the rural areas are buying up the docs practice, esp in IL. If you're a new doc and you're specialized they might even pay off your school debt to get you in the area. It's happening more and more in rural IL where malpractice ins premiums are so high the doc can't make it.

[Flexyahmind]

First I want to thank all of you for your input. I really do appreciate it.

 

I do not know everything about both professions and I am attempting to volunteer/shadow some docs in different areas of medicine as well as PAs (I'm 89% sure that I would rather work in EM or Ortho. Surg.). But I do feel I have a good enough understanding to know that one of these is the path for me.

 

Currently I'm 26 years old. I became a paramedic roughly at 21-22 and worked for a little while in EMS on the bus, taught ACLS, PALS, and EMTs for a little while, then started working a little bit in occupational health, and then on construction and refinery sites as like a medical safety kind of person. I also in the last 5 or so years have been going back to school periodically taking, basically, premed classes because I wanted to further my knowledge. When I became a paramedic, though, I had this lingering feeling of just wanting to go to med school. But I wasn't doing the best (3.0-3.3gpa) in the premed courses and wasn't mature enough back then to really apply myself to doing well so that I could get into and through med school and residency. Mind you I'm not just a drone trying to get the top grades but understood what it took to be competitive and really do enjoy (with all my heart... after my lady) science and medicine.

 

In late 2009 I was laid-off and for awhile before that I was taking fire science courses because I thought that was probably the next best step in my career. But while being out of work I was staying in good physical shape, in case of any opening positions (especially for SFFD) in fire departments, and while training I injured my knee (compl. ACL tear, MCL sprain/tear, Meniscus tear, and fracture of both femur and tibia at the knee joint). So, I possibly ended any current opportunities in my career. So I decided, instead of sitting on my butt at home while going through rehab and being on a waitlist for surgery, I would go back to school. While in school one of my paramedic mentors introduced me more to the profession of PAs and I was really intrigued. Now a year later while trying to fulfill pre-reqs (having a 4.0 for the past year!) and researching more and more into the profession I almost feel like I might as well go to med school. But as I mentioned in the original post of this thread I need to work out some of those internal dilemmas and was seeking some advice and guidance. I know I need to go with my heart and do what's best for me. But as I said I have read and researched a lot but definitely don't know enough about the day-in-the-life of PAs and MDs as well as the route to get there. Also even though I kind of know what I would like to do (EM or Ortho) I would and do enjoy hearing about others experiences as well as the great input I have received so far. So if it's ok I would enjoy to keep this post going.

 

Again thank you for all the advice/input. It so far has been more than I expected :smile:.

Take care and always be safe,

 

S

[ohiovolffemtp]

I'm a firefighter/paramedic with a BS in a non-medical field: computer science. I looked into both medical school and PA schools. Here are some of the key things I found:

1. The prereqs are very similar. In fact, the med school prereqs seem to be less. On the other hand, the MCAT is a significant challenge.

2. DO schools are far more friendly to non-traditional students than MD schools - at least of the ones I talked to.

3. PA would put me back into the workforce in ~2.5-3 years vs. ~7 years for MD/DO school (4 yrs med school +3 yrs @ ~$40K/yr for residency)

 

So, I started taking prereqs and researched both further. I found that visiting schools and talking to practioners was the most helpful to me.

 

Other factors: I was 47 when I started taking classes. I'll be starting PA school in a few months at age 53. Here's how I chose that path:

 

I looked at the number of years I'd have to work to break even, based on projected physician vs PA income. The break even point was age 65 for me: 12 years of work as a PA vs. 3 years of residency and 8 years as an MD/DO. Along the way to physician, I'd dip much deeper into debt and have more years of a lifestyle too hectic to maintain a good relationship with my significant other. I also looked at the day-to-day life of the practioners. In EM and primary care, the differences are much less between PA & doc than in other areas and I'm leaning towards EM or primary care.

 

Net: PA hit my personal "sweet spot". Were I making this choice 10-15 years earlier in my life, the balance might have swung the other way. I'm not sure though. That was in the middle of the years of paying for children.

 

"At your age" (doesn't that make me sound old), I'd be more heavily influenced by which daily life I wanted to lead. No just the income, but especially which job seemed most satisfying to me. Hopefully as a medic you have contacts with docs & PAs that you can talk to & shadow. That's how you'll get the information to decide what's best for you.

[Iain1028]

You did forget:

 

PAs

 

Very real potential to have 100K + in student loans.

 

Please add that to your list.

[Flexyahmind]

Yeah but 200K+ is a bigger con for MD

 

And thanks for your input ohiovolffemtp.

 

I know I'm still young. And I shouldn't worry about time but I have been with my significant other for 5 years and would like to have a family at a decent age. I also know and have heard how med school and residency is a relationship killer. Also I got into a little discussion with one of my residents surgeons I met with for my pre-op appointment and he said med school can destroy relationships but it's about what you want and he said "MD long route to practicing, but PA short route to working and making good money." But I know there has to be plenty of people (probably more so wealthy) who have had relationships or families, that may along the way have gone through struggles, but in the end persevered and were fine during residency or afterward (correct me if I'm being naive).

 

So although I am a paramedic I'm definitely not the most experienced one, but I also didn't work in the field out here. I worked for a little bit in Virginia. Some of the contacts I have developed out here, from volunteering, are with medics and fire fighter medics and it was all while trying to pursue fire. And as you know (from being a ff medic) it wouldn't have been in my best interest, or proper etiquette, to be very social or showing more interest in making connections or chit chatting with docs or hospital personnel, as kind of a back up internal motive, when I'm trying to prove myself and/or fit in with the ALPHAS on the bus or engine.

 

I would say that the cost of school and money to be made is roughly influencing 30% of my decision obviously because in all reality (besides just for the love of it) we wouldn't go through all this hard work, training, and debt to get paid crap and be in debt the rest of our lives. But the 70% influencing my decisions are more related to time, family, stress, and future contentment (or better stated personal satisfaction).

 

I haven't really done much research on DO schools and that's probably because of a stupid unconscious, now conscious;), bias (I don't know where from!) that DO schools are like unattractive med schools or DOs are "wannabe" MDs that have a different method (Allopathic vs. Osteopathic/Holistic, Joking) of approaching medicine. But seriously I think, from what I can remember, that they both get pretty much the same education accept osteopathic learns more about musculoskeletal science and they're somewhat less respected in and out of the U.S. But please enlighten me a little bit on the comparisons and contrasts between DOs and MDs and their respective schools because I have seen a lot of people saying DO instead of MD but truly don't understand why.

 

Also ohiovolffemtp are you saying that EM MDs and PAs aren't really that much different? And what about Surgical PAs in Ortho Surg and Ortho Surg MDs?

 

Sorry for the novel! But appreciate it if you've endured it this far.

 

Thank you,

S

[delco714]

You did forget:

 

PAs

 

Very real potential to have 100K + in student loans.

 

Please add that to your list.

 

I know I will have near that (b.c of interest by graduation day)

[EMEDPA]

surgical fields are very different for pa vs md. docs operate, pa's assist. outside of the o.r. there are fewer differences.

primary care: I would challenge you to tell the difference between an experienced pa and md.

em: similar, but the docs get most of the high end procedures/cases although an experienced em pa can work solo at a smaller, low volume, or rural dept.