PA vs. MD? Seriously stressing

[wisemakl]

One of the biggest things that pulled me into PA world was the ability to be indecisive.  There are many areas of medicine that I'm interested in.  I love learning and I see myself changing specialities during my career.  

 

It also allows for a financial benefit.  Before you have children you can work in a high-stress, high hours, speciality - where generally you will make more money.  Then once you have a family, you can trade for the more "normal" work hours.  

 

Of course the trade off is that when you switch you haven't spent 5years training in one speciality.  So it takes time to learn and get good at your craft.

 

 

Just a thought! 
 

[mashlee]

Yup. With the extra time in school, time in residency, higher loan amounts, accrued loan interest, missed income, and missed income interest, the average doc (male) doesn't pull that far ahead in primary care vs. the average male PA in same.

 

One reason why a lot of physicans try to go into other specialties.

 

 

This is interesting, but I wonder at what age you start school and what age you retire, this would be true. Of course with med school, you make a big time and financial investment but your earning potential is very high. I'm curious because I have and kind of, and, still am thinking about med school, but i wouldn't start med school till i'm 31, but I will be starting PA school this year (i'll be 28). I didn't make the choice to go PA based just on finances, but I feel like I would honestly make about the same over my career as a PA rather than a family medicine doc. If I started Med school at age 24 or 25 I think med school would be the better financial choice then. I can't really crunch the numbers, but does this sound right to anyone else?

[PACdan]

This is interesting, but I wonder at what age you start school and what age you retire, this would be true. Of course with med school, you make a big time and financial investment but your earning potential is very high. I'm curious because I have and kind of, and, still am thinking about med school, but i wouldn't start med school till i'm 31, but I will be starting PA school this year (i'll be 28). I didn't make the choice to go PA based just on finances, but I feel like I would honestly make about the same over my career as a PA rather than a family medicine doc. If I started Med school at age 24 or 25 I think med school would be the better financial choice then. I can't really crunch the numbers, but does this sound right to anyone else?

 

If you went into family medicine, as things stand right now, the difference on paper is *little* to none. The report follows careers and hours worked within constraints (ie, they didn't look at physicians or PAs who worked under or over certain limits). You would make a lot more if you worked into your 80s as an FM doc over an FM PA from your current starting point, or if you worked 70 hour weeks. Most people don't do either of those. Although I remember hearing about a 90 year old heart surgeon in California, he must be rolling in the dough from his 60+ years of practice, haha!

 

We're the same age btw. I find it interesting that you mention starting med school at 31? Are you planning to jump straight from your PA education into a bridge? I would definitely work for a few years as a PA (you might lose any desire for MD/DO after that). Plus the work experience would be necessary/valuable. Plenty of people start med school in their 30s and 40s. But in family medicine, if that is your calling, I would think being a PA would fulfill all your desires.

[mashlee]

 

We're the same age btw. I find it interesting that you mention starting med school at 31? Are you planning to jump straight from your PA education into a bridge? I would definitely work for a few years as a PA (you might lose any desire for MD/DO after that). Plus the work experience would be necessary/valuable. Plenty of people start med school in their 30s and 40s. But in family medicine, if that is your calling, I would think being a PA would fulfill all your desires.

starting med school at 31 would be instead of PA school and it was kind of a rough estimate of the time to take more prerequisites study for and take the MCAT and apply and begin. And I appreciate your input, I can't help but occasional question my decision to go to PA school especially when I talk to friends that are starting med school or are currently in it, but I would say my/their reasoning for going to med school probably isn't the best reasoning (money, title, ect.). After listening to the posters on the forum, it seems like the money this isn't really so different, unless i specialize (which i likely wouldn't). It makes the most sense at this point (starting PA school in a few months) to just keep with the plan and if down the road I feel like going back to school is the right choice it won't be too late.

[PACdan]

starting med school at 31 would be instead of PA school and it was kind of a rough estimate of the time to take more prerequisites study for and take the MCAT and apply and begin. And I appreciate your input, I can't help but occasional question my decision to go to PA school especially when I talk to friends that are starting med school or are currently in it, but I would say my/their reasoning for going to med school probably isn't the best reasoning (money, title, ect.). After listening to the posters on the forum, it seems like the money this isn't really so different, unless i specialize (which i likely wouldn't). It makes the most sense at this point (starting PA school in a few months) to just keep with the plan and if down the road I feel like going back to school is the right choice it won't be too late.

It's never too late, until it's too late. :)

 

I've said before, and I think it rings true, that as smart and motivated as most PA candidates are; thinking about med school is a natural progression of thought. Sometimes it hangs like a temptation, even after you get into school. But ask yourself this: If you didn't get into PA school this year, would you now be thinking about med?

 

Humans tend to want "the other", the thing they don't have. I like to remind myself how hard we worked to get into PA school. And how many others that didn't get in desire our place. The same as medical school. It makes me appreciate the opportunity more.

 

 

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[Dunedain]

My daily stroll around SDN makes me not want to be a MD.....hehe

[EMEDPA]

My daily stroll around SDN makes me not want to be a MD.....hehe

so be a DO ( aka a physician with a personality)

[PACdan]

My daily stroll around SDN makes me not want to be a MD.....hehe

 

I can't venture into Mos Eisley anymore without a lightsaber.... I mean SDN.

[JohnnyM2]

Of course nothing is static. What about future earnings of both professions? On the one hand, government, insurers and hospital systems are conspiring to make MDs do more for less and, on the other hand, some PAs complain of saturated markets, particularly with all the NPs being graduated. Will these factors lead to a decline in PA pay? I wonder what the MD/PA trade off will look like some years from now.

Another issue is that many MDs end up not getting paid for a lot of their work hours. I believe this is less true for PAs. Any thoughts about this?

 

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[PACdan]

Of course nothing is static. What about future earnings of both professions? On the one hand, government, insurers and hospital systems are conspiring to make MDs do more for less and, on the other hand, some PAs complain of saturated markets, particularly with all the NPs being graduated. Will these factors lead to a decline in PA pay? I wonder what the MD/PA trade off will look like some years from now.

Another issue is that many MDs end up not getting paid for a lot of their work hours. I believe this is less true for PAs. Any thoughts about this?

 

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I came in being okay with working in Nowhere, USA. I like small, rural, desert places. It appears that a lot of PAs that are intransigent to moving away from big cities, saturated markets, etc. are the ones experiencing the most headaches. But I understand that's a perk of not being married/having kids/owning a home.

 

Here's a fun tidbit I read; between failing med school, failing to pass usmle steps, and failing to match, 7-8% of those that are accepted to med school never complete the journey to practicing medicine.

 

I wonder what the rate of failure for PA is?

 

 

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[primadonna22274]

I'm guessing the PA failure rate is a little lower because the PAs have far fewer mandatory exams than physicians--each of those is a weeding-out place, and so is the match, then in-service exams in residency, then board exams to obtain full licensure and board certification. The whole process is very expensive and I shudder to think of what people do when they get far into training, deep into debt, and then fail at some critical juncture. Physicians are one of, if not the, most highly regulated professions. In fact ABIM just announced it would change Recertification for internists from every 10 years to every TWO!!! Now, who does that benefit? The exam administrators who collect a healthy fee for each board exam. Testing has become burdensome and excessive.

I, however, do not suggest that PAs should be any less frequently tested than they are currently.

[PACdan]

Yikes! That is quite a burdensome recert process. I hope that doesn't trickle down into PC/FM. We can't know everything, we are human after all.

 

Maybe I'm just nostalgic for the old days of the town doctor or my pediatrician who practiced in a small office for 40 years. If they didn't know something, they referred on out. Heck, it was his constant referrals that finally got me to someone who said, oops, you have cancer.

 

 

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[EMEDPA]

 I shudder to think of what people do when they get far into training, deep into debt, and then fail at some critical juncture.

they hang out at sdn and say that PAs are under qualified and that med school grads without residency should be the new "midlevels". seriously.

[PACdan]

they hang out at sdn and say that PAs are under qualified and that med school grads without residency should be the new "midlevels". seriously.

And get mad that they somehow aren't entitled to challenge the PANCE.

 

God forbid a very smart PA offers to challenge all three USMLE steps. All hell would break loose.

 

 

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[Maverick87]

I came in being okay with working in Nowhere, USA. I like small, rural, desert places. It appears that a lot of PAs that are intransigent to moving away from big cities, saturated markets, etc. are the ones experiencing the most headaches. But I understand that's a perk of not being married/having kids/owning a home.

 

Here's a fun tidbit I read; between failing med school, failing to pass usmle steps, and failing to match, 7-8% of those that are accepted to med school never complete the journey to practicing medicine.

 

I wonder what the rate of failure for PA is?

 

 

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I recently read at an article that was a few years old (I think 2010-2011 timeframe). About 6% (or about 1,000 American medical school graduates) failed to match.

 

I also read that they're increasing medical schools and classes by about 5,000 students per year, but they are not increasing residency spots. 

 

In my opinion, this is as good a reason as any to not go to medical school as any.

[PACdan]

I recently read at an article that was a few years old (I think 2010-2011 timeframe). About 6% (or about 1,000 American medical school graduates) failed to match.

 

I also read that they're increasing medical schools and classes by about 5,000 students per year, but they are not increasing residency spots.

 

In my opinion, this is as good a reason as any to not go to medical school as any.

It's true that new MD and DO schools are forming and older schools are increasing class size, but residencies slots are not increasing to match. Apparently this is tied to that fact that residencies are subsidised by the federal government and they are not increasing available funding at this time.

 

It's a small fraction that fail to match, and I assume that SOME of those individuals only have themselves to blame.

 

However, it is a small comfort that we are not entrenched in that headache...(yet).

 

 

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[Maverick87]

It's true that new MD and DO schools are forming and older schools are increasing class size, but residencies slots are not increasing to match. Apparently this is tied to that fact that residencies are subsidised by the federal government and they are not increasing available funding at this time.

 

It's a small fraction that fail to match, and I assume that SOME of those individuals only have themselves to blame.

 

However, it is a small comfort that we are not entrenched in that headache...(yet).

 

 

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Exactly.

 

Right now, a small fraction of medical school graduates didn't match. This number will likely grow as more medical schools are created. And more medical schools will be created because they are cash cows.

 

Also, I don't think this will happen to the PA profession. If it does though, in my opinion, the same thing will happen as what happened in the law profession. The established guys will be fine, but the new guys will be screwed. By the time this all plays out, we'll be the established guys. ;)

[PACdan]

By the time this all plays out, we'll be the established guys. ;)

 

Hell yeah we will. *slow motion shirtless high-five on the beach volleyball court, as Kenny Loggins' Playing With The Boys sounds in the distance*

[JohnnyM2]

It's true that new MD and DO schools are forming and older schools are increasing class size, but residencies slots are not increasing to match. Apparently this is tied to that fact that residencies are subsidised by the federal government and they are not increasing available funding at this time.

According to an article (a while back), in The Wall Street Journal, residencies are funded thru Medicare which the ACA decapitates in order to give the appearance of actually saving money.

 

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[coloradopa]

Here's a fun tidbit I read; between failing med school, failing to pass usmle steps, and failing to match, 7-8% of those that are accepted to med school never complete the journey to practicing medicine.

 

I wonder what the rate of failure for PA is?

 

 

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The PA graduation rate is around  95%. If you throw in those who can't pass the PANCE I would bet the overall rate is around 7%.