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

[EMEDPA]

lots of great jobs in AK at high rates of pay. many rural and/or solo jobs there. some of my best friends work per diem up there in 2 week blocks a few times/yr for ridiculous money.

[meatheadPA]

I might look into that as well if I dont do the DO route. 

 

What kind of patient load does your friends see, and what ailments primarily? What kind of compensation and benefits do they receive?

[EMEDPA]

full spectrum primary care and emergency medicine + occupational medicine, many sites are at occupational facilities or rural facility as only provider on site.

low volume. full range of acuity. great pay (120k+) with full benefits for full time and 75/hr for locums + room/board/transportation.

[SocialMedicine]

I think a strong intelligent civ PA can make a name for himself in emergency medicine and have an autonomous position. Even in academic circles. I am not so sure PAs will be full professor and PIs on major studies in the academic ER in the near future. At least with any frequency. The training model and ladder for PAs doers not lend itself to that.

 

I find a good amt of PAs who are in scut positions with low autonomy are those who are just not that good at what they do or professionally aggressive. Of course there are plenty of exceptions.

 

Your situation with military background (used to changing environments) and tuition reimbursement is unique and if you are fine not starting to earn a decent salary until 36 this path makes sense. Especially if you have this research interest and desire employment in an academic setting. 

 

I would envision a scenario where you did not match into an ER residency. Will you still be happy? I have a good buddy who could not match into ED and now works as a hospitalist and is not very happy.

[meatheadPA]

full spectrum primary care and emergency medicine + occupational medicine, many sites are at occupational facilities or rural facility as only provider on site.

low volume. full range of acuity. great pay (120k+) with full benefits for full time and 75/hr for locums + room/board/transportation.

 

Ya ill have to look into something like that if I dont go the DO route. I think either way, I will apply and let that guide my decision. I could transfer into the Alaska National Guard and serve out to 20yrs in an aviation unit or something fun. That salary+benes with the NG bonuses and pay would come out about the same as primary care physician pay. Plus it sounds like the pipeline gigs would be interesting with a mixed bag of things. 

[meatheadPA]

I think a strong intelligent civ PA can make a name for himself in emergency medicine and have an autonomous position. Even in academic circles. I am not so sure PAs will be full professor and PIs on major studies in the academic ER in the near future. At least with any frequency. The training model and ladder for PAs doers not lend itself to that.

 

I find a good amt of PAs who are in scut positions with low autonomy are those who are just not that good at what they do or professionally aggressive. Of course there are plenty of exceptions.

 

Your situation with military background (used to changing environments) and tuition reimbursement is unique and if you are fine not starting to earn a decent salary until 36 this path makes sense. Especially if you have this research interest and desire employment in an academic setting. 

 

I would envision a scenario where you did not match into an ER residency. Will you still be happy? I have a good buddy who could not match into ED and now works as a hospitalist and is not very happy.

I would really only want ER med or anesthesiology. I'm pretty sure I could match into one of those. Historically, they are about mid pack for competitveness. Above internal med but below gen surg/rad

[coloradopa]

I would really only want ER med or anesthesiology. I'm pretty sure I could match into one of those. Historically, they are about mid pack for competitveness. Above internal med but below gen surg/rad

Take a look at this:

http://www.nrmp.org/wp-content/uploads/2014/09/Charting-Outcomes-2014-Final.pdf

For independent applicants (which includes DOs) the match rate was 70% for anesthesia and 59% for EM. This compares to 32% for general surgery and 70% for rads . One thing to remember is that surgery includes prelim positions which attracts a lot of non-US applicants who have a lower acceptance rate. Also the step 1 scores are slightly above the mean at 230 for all four. 

 

Things will change in the next 3-4 years. ACGME and AOA are merging which means that osteopathic residencies will be open to non osteopaths. This has a potential to make these more competitive. In the meantime both Osteopathic programs and Allopathic are increasing their numbers (the effects should be fully realized in 3-4 years. Finally, traditionally DO students have scored lower on step 1 than allopathic students. However, given the merger, more programs may start accepting COMLEX (that's the hope anyway). Fundamentally you have to be above average in a very competitive group. Remember 1245 Allopathic grads didn't match at all this year. 

[PACdan]

^^^ Fact. I think anyone entering medical school needs to realize that there is always the possibility of not matching into their desired field. And all of them should be okay with the possibility of a FM residency.

[cc56]

MeatheadPA-  Why not finish out active duty with the military?  I think you said you have 8 years in, so 12 to go and you get a full retirement.  You have already said that you like the autonomy and what you have done.  Look into the Army ER PhD program and get more educated on the military dime.  http://www.bamc.amedd.army.mil/staff/education/allied-health/empa/  I don't knw much about it, but saw it online and thought it might be a sweet gig.  After 20 years you can go teach PA school, and work ER.    If you want to be a Doc then I say do it, maybe you can get a residency in the military after DO school. 

 

On a side note, I was in the Guard and loved it.  I got out for a Civ job, I want to go back in.  Before you get out take a second to think about it, and make sure you will not miss it.  I know I do not miss AD, but realllly do miss the Guard.   Good luck to you. 

[ventana]

how about USUHS??

[Maverick87]

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. 

We seem to be in a similar (though certainly not identical) situation. So I'll comment on what I will likely do.

 

First, I'm a current Air Force PA that will also be leaving the military soon. I am considering this program as well. I have only been in for 3 years and did HPSP so I don't have the GI bill. My stats are not as good as yours. And, after some experience in various subspecialties, I really can only see myself doing either family medicine or internal medicine, so I would be definitely okay with doing the primary care track.

 

With that said, I, like you, have never practiced in the civilian world. I have no idea what it's like (as either as PA or a doc), aside from my clinical rotations. 

 

However, I also read the student doctor forums often and it seems that the grass is not greener over there. They have their own sets of issues. That combined with the horrors that I've read and heard about when it comes to residency, declining reimbursement rates for docs, and the high suicide rates among docs made me decide to hold off on it a bit while I make a more informed decision. I'd like to work in the civilian world for a year before I apply. I will likely get either a full time job and per diem job or a few part time jobs just to have the ability to observe different work places.

 

Of course, this is just me. I suggest making a pros and cons list.

[Maverick87]

how about USUHS??

Based on what I've seen, I wouldn't recommend this to anyone. It's a 14+ year commitment (4 years for med school, 3+ for residency, then 7+ to make up this time). A lot can change in one's life in 14 years to make this into a bad decision lol. My SP is experiencing this right now. She has frequent (almost daily) breakdowns in her office and is seeing mental health once a week. She still has 6 years left. I do not envy her.

[meatheadPA]

Thanks again everyone. The higher rank you get in the Army, the more bureaucracy and less clinical time you get. I have maybe one more duty assignment before I get sucked out of the clinic. I would rather go out to the guard and finish up 20 there while working civilian. Also, the year long deployments every couple years with JRTC, NTC and all required training throw in during the transition time really sucks.

 

As for the Army Baylor DHsc in Emed program, I wont do that. Essentially you are doing half of the Emed Physician residency and receiving a Phd at the end. The education would be great, but in the end, you are still a PA. Not really increasing scope of practice. You might as well go to med school instead. Its also a 2 for 1 trade i believe, so one would owe and additional 3 yrs. A colleague physician friend is an instructor at BAMC for the program. There is a 6 month program done through BAMC/SAMC in Emed that might be worth it. Its a TDY course, so no increase TIS.

 

USUHS is not that great of an idea. Like someone else mentioned, its a large service commitment. Its a military school, so you must conform to the AR 670 and every other regulation out there. It doesn't count towards retirement either. HPSP is a better option

 

Maverick, sounds like we are in the same predicament. I keep hearing about all the cons of being a physician, but find it hard to believe that PAs dont suffer from the same problems. When I was in school, PAs and Emed Docs had the same schedule, alternated charts and saw the same patient load. What makes being a Doc more stress full than a PA? It is true that reimbursement is becoming better for PAs, but in the end, I doubt PA pay will change that much. Maybe adjust for COLA, but never 1:1 match. I like your idea of working a year and then applying. Especially if I can get a job in rural Alaska working 2weeks on 2 weeks off. Ill probably look into this when Im done with the current deployment. It might enlighten me. 

 

As for residencies, 70% match is outstanding and 59% is pretty good. Internal medicine is not a bad option either. It leaves one open to fellowships down the road.

 

All in all, I still firmly believe that the PA profession is one, if not the best, career in the world.  I feel working in Emed is about the only time being a physician is worthwhile. You have no ceiling for capabilities and have the option of incorporating new procedures and publishing case studies with no barriers. Also, you never have someone hovering over you critiquing your work. You are consider a subject matter expert. Also, 120K/yr vs 300K/yr for basically the same work and responsibility. You could have the option of working part time and still make more. This would allow more time for academics, research and volunteering.

 

Fam/peds/gen internal has no benefit in my mind. PA is a much better route. Your scope is equivalent and pay is as well.180k vs 100k without any overhead. Surg and Sub-Spec it just way too much schooling, too much call and too many hours a week. Also, too much liability.

[Maverick87]

Thanks again everyone. The higher rank you get in the Army, the more bureaucracy and less clinical time you get. I have maybe one more duty assignment before I get sucked out of the clinic. I would rather go out to the guard and finish up 20 there while working civilian. Also, the year long deployments every couple years with JRTC, NTC and all required training throw in during the transition time really sucks.

 

As for the Army Baylor DHsc in Emed program, I wont do that. Essentially you are doing half of the Emed Physician residency and receiving a Phd at the end. The education would be great, but in the end, you are still a PA. Not really increasing scope of practice. You might as well go to med school instead. Its also a 2 for 1 trade i believe, so one would owe and additional 3 yrs. A colleague physician friend is an instructor at BAMC for the program. There is a 6 month program done through BAMC/SAMC in Emed that might be worth it. Its a TDY course, so no increase TIS.

 

USUHS is not that great of an idea. Like someone else mentioned, its a large service commitment. Its a military school, so you must conform to the AR 670 and every other regulation out there. It doesn't count towards retirement either. HPSP is a better option

 

Maverick, sounds like we are in the same predicament. I keep hearing about all the cons of being a physician, but find it hard to believe that PAs dont suffer from the same problems. When I was in school, PAs and Emed Docs had the same schedule, alternated charts and saw the same patient load. What makes being a Doc more stress full than a PA? It is true that reimbursement is becoming better for PAs, but in the end, I doubt PA pay will change that much. Maybe adjust for COLA, but never 1:1 match. I like your idea of working a year and then applying. Especially if I can get a job in rural Alaska working 2weeks on 2 weeks off. Ill probably look into this when Im done with the current deployment. It might enlighten me. 

 

As for residencies, 70% match is outstanding and 59% is pretty good. Internal medicine is not a bad option either. It leaves one open to fellowships down the road.

 

All in all, I still firmly believe that the PA profession is one, if not the best, career in the world.  I feel working in Emed is about the only time being a physician is worthwhile. You have no ceiling for capabilities and have the option of incorporating new procedures and publishing case studies with no barriers. Also, you never have someone hovering over you critiquing your work. You are consider a subject matter expert. Also, 120K/yr vs 300K/yr for basically the same work and responsibility. You could have the option of working part time and still make more. This would allow more time for academics, research and volunteering.

 

Fam/peds/gen internal has no benefit in my mind. PA is a much better route. Your scope is equivalent and pay is as well.180k vs 100k without any overhead. Surg and Sub-Spec it just way too much schooling, too much call and too many hours a week. Also, too much liability.

Yeah, I might even stay in a bit longer than my commitment just to get some of the GI benefits. I haven't deployed yet either (which is something that I've wanted to do) so I have my readiness people potentially hooking me up with an army deployment. We'll see.

 

As far as specialty, it really depends on what you like. I work in a family health clinic now and I like managing my patients' care. I also really like hypertension/hyperlipidemia/diabetes. So I could see myself being a family medicine doc or a hospitalist. The ER is a bit too fast-paced for me.

 

In any event, I realize that the physician compensation report says that family med docs make an average of about 180k, but I have many friends in this specialty and they all make >200k. Granted, they are good at what they do, but I plan to be too (in whatever I end up doing). 

 

With the docs vs. PA argument, it really depends on who you talk to. In my clinic right now, I work with 2 family practice docs. One is very happy about her choice and would do it again. The other is miserable and is dissuading me from med school. Two docs, same practice, opposite extremes in their responses.

[meatheadPA]

Ya its hard to get a good grasp because of the conflicting opinions... Remember though, if you are making 200K in FP, you are probably a partner or owner. Lots of overhead with that. Think at least 20K malprac and other associated partner fees up to a total out of pocket expense of 30K. You can pull in 120+K in FP if you work as hard as the owners and they may offer a partnership. Most NG FP that ive worked with make roughly 180ish. You could stay in the air guard. The bonus I believe is about 20K still (id have to do some research). That could be a nice supplement and could still get a deployment..

 

As for a deployment, doesnt the AF still have 90 day boots on ground deployments? YOu should definitely pick up one of those. Also, the imminent danger pay, combat pay, family separation pay and tax free pay is great.

[Maverick87]

Ya its hard to get a good grasp because of the conflicting opinions... Remember though, if you are making 200K in FP, you are probably a partner or owner. Lots of overhead with that. Think at least 20K malprac and other associated partner fees up to a total out of pocket expense of 30K. You can pull in 120+K in FP if you work as hard as the owners and they may offer a partnership. Most NG FP that ive worked with make roughly 180ish. You could stay in the air guard. The bonus I believe is about 20K still (id have to do some research). That could be a nice supplement and could still get a deployment..

 

As for a deployment, doesnt the AF still have 90 day boots on ground deployments? YOu should definitely pick up one of those. Also, the imminent danger pay, combat pay, family separation pay and tax free pay is great.

Nah, it's usually 6 month deployments. Though, I'm not sure how much time they actually spend in Qatar getting ready to go to Afghanistan lol. I looked into AF deployments, but there are not in the pipeline for PAs right now. Supposedly, there are plenty of army deployments though.

 

And none of the people that I know in FP that make >200k are part owners. They work for places like Kaiser though. So they have great bennies too.

 

On another note, I re-read your initial post and you said something about a scholarship that could cover the rest of your school. What scholarship is that?

[meatheadPA]

Nah, it's usually 6 month deployments. Though, I'm not sure how much time they actually spend in Qatar getting ready to go to Afghanistan lol. I looked into AF deployments, but there are not in the pipeline for PAs right now. Supposedly, there are plenty of army deployments though.

 

And none of the people that I know in FP that make >200k are part owners. They work for places like Kaiser though. So they have great bennies too.

 

On another note, I re-read your initial post and you said something about a scholarship that could cover the rest of your school. What scholarship is that?

 

Typically all medical students get at least a small scholarship. There are thousands of private donors that supply funds for medical students. The post 911 GI will cover roughly 90% of the cost though

[jyonke07]

I've looked into this myself. It sounds attractive for many reasons but always have to come back to why I chose to become a PA 10 years ago. It wasn't for prestige or money or any other accolades. It would be nice to be respected for the intellect and skill I do have. Sometimes in small ways that doesn't seem to be the case. That is the only disheartening aspect I didn't completely prepare for. If our healthcare culture changes, and in time I do believe it will, then do you really feel you still need to do this. Or, do you already have the foundation to continue learning and expanding your clinical abilities, within the title of PA? I believe our power is endless and we can be great clinicians with great outcomes as we are. I've had to grapple with this question for some time. Is it that I just want the title? Or, is it that I want simply the respect I feel I deserve to feel justified in my own skin as a provider? One thing I do know, is this is not a true bridge program. None yet exist. It is 3 years and more intensive than traditional 4 years of medical school including summers. It does not take your PA training or experience into account and no credit is given beyond the admissions process. Until, a true bridge exists where our past counts towards something tangible, than it isn't worth it to me on those grounds alone. In the meantime, despite having to sling a great deal of controversy and disrespect from time to time, we are part of a movement. The PA has already gained so much more demand and respect in my state than just 7 years ago. I think one day it will be on par with the DO and MD at least in terms of knowledge, opportunity and social respect.

[KMD16]

^ All good pointer.

 

Exceptions for the last two sentences.

 

Full independent. Full insurance recognition. And, breaking away from BOM is the only thing that will set us apart IMHO.

[meatheadPA]

Ya PAs will never be fully independent, nor do I expect us to be. It is not our role. I dont mind the title. I chose to be a PA, not HAD to be. For me, it was the quickest way to action. Id still be in residency at this point.

 

But like stated before. Your scope of practice and capabilities is limitless. That is the biggest point as a MD/DO

[primadonna22274]

I just don't see full independence for PAs. Maybe I lack vision. I went back to med school and am slogging through residency working twice as many hours for half of my PA salary to gain independence.

I do support graduated autonomy for experienced PAs, but no way no how does a 27-month masters program with 12-15 mos rotations and no mandatory residency prepare anyone for independent practice. That's just dangerous.

[EMEDPA]

I just don't see full independence for PAs. Maybe I lack vision. I went back to med school and am slogging through residency working twice as many hours for half of my PA salary to gain independence.

I do support graduated autonomy for experienced PAs, but no way no how does a 27-month masters program with 12-15 mos rotations and no mandatory residency prepare anyone for independent practice. That's just dangerous.

bit of a fluke this week: I am working 95 hrs in 6 days covering sick calls at 2 places + my own shifts:

24. 12, 21, 12, 14, 12

[primadonna22274]

Lol and you'll probably make 3-4x what I make all month lol.

[Guest Paula]

I just don't see full independence for PAs. Maybe I lack vision. I went back to med school and am slogging through residency working twice as many hours for half of my PA salary to gain independence.

I do support graduated autonomy for experienced PAs, but no way no how does a 27-month masters program with 12-15 mos rotations and no mandatory residency prepare anyone for independent practice. That's just dangerous.

 

How on earth have NPs been allowed to gain full autonomy?  I do know the answer and it has to do with politics and the nursing lobby and an active national NP organization, plus they are not under a medical board.  But, really then I think you are saying NPs are dangerous?   I agree with graduated autonomy, BTW for experienced PAs.  I'm not here to bash NPs........you get my drift tho. 

 

I truly think that now that you are on the other side your viewpoint has changed and is to be expected, especially for the volumes of knowledge you are expected to learn in residency.  In the end, should you be a SP for a PA or NP you will be an excellent one.  

[KMD16]

No one is independent in true life but on paper (legislation wise) they are (NP & MD). Where does PAs falls then? Dependent provider? We've got to break away. Cut us loss.