Do you REALLY want to be a PA?

[Firemedic13]

So...what if I'm twenty and I don't want to be a Doctor?

 

Why would you want to practice medicine, but not be happy as an MD or DO?

 

That is what I would be curious to know.

[acozadd]

Why would you want to practice medicine, but not be happy as an MD or DO?

 

That is what I would be curious to know.

 

Some people value free time and the ablity to dictate our schedule/the lateral mobility that the PA profession offers. With PA school I can have a say over my schedule after 2 years, get to enjoy the better half of my twenties, and "live life." If I chose med school, I would have 4 years of school/clinicals (no say over schedule) and then 3-9 years of residency (again, no say over schedule). I wouldn't be able to enjoy my twenties, I would have 5x the debt, and I would be locked in to that field that I chose.

 

Seems like a lot of perks to me, sign me up!

[Firemedic13]

Some people value free time and the ablity to dictate our schedule/the lateral mobility that the PA profession offers. With PA school I can have a say over my schedule after 2 years, get to enjoy the better half of my twenties, and "live life." If I chose med school, I would have 4 years of school/clinicals (no say over schedule) and then 3-9 years of residency (again, no say over schedule). I wouldn't be able to enjoy my twenties, I would have 5x the debt, and I would be locked in to that field that I chose.

 

Seems like a lot of perks to me, sign me up!

 

So you will take 3 years of school/clinicals(unable to set your own schedule)... followed by (most likely for 90% of PAs) 20+ years of being an employee of an SP who dictates your schedule. Yes, I can see how that would be better than having the ability to own or be a partner in your own practice and set your schedule while making twice to three times the money to pay off your debt.

 

PA is for certain people, and is an awesome career. But MD/DO have a lot to recommend them, let's face it. And if you are 22 years old, I really don't see the downside to putting in the extra few years to be an MD/DO.

[blondknotdum]

If I went to med school I wouldnt be able to start a family until my thirties. That's a major perk of pa school for me personally. I want to have children when I'm young enough to enjoy them. Hence practitioner, but not md or do.

[acozadd]

So you will take 3 years of school/clinicals(unable to set your own schedule)... followed by (most likely for 90% of PAs) 20+ years of being an employee of an SP who dictates your schedule. Yes, I can see how that would be better than having the ability to own or be a partner in your own practice and set your schedule while making twice to three times the money to pay off your debt.

 

PA is for certain people, and is an awesome career. But MD/DO have a lot to recommend them, let's face it. And if you are 22 years old, I really don't see the downside to putting in the extra few years to be an MD/DO.

 

For me it is 2 years of school where I cannot dictate my schedule, and while I cannot completely dictate my schedule when I am done obviously, I can search for positions that match the hours I desire, while not having to study night in and night out/work 80 hour weeks. Oh ya and Ill be paid a decent salary at the same time so that I can enjoy/pursue the things I wish-- travel BEFORE having children, etc.

 

I can start in a surgery position and move to something a little slower pace or low key later in my career if I wish. Really my possibilities in terms of specialty are endless... I do not have to complete the ridiculously long residencies that come with working in that field as a doc.

 

There are other reasons, that is just the start.

 

Edit- On a similar note, what if you complete med school only to not match into the field you desire? All of that time and effort only to end up in a field that you might not really enjoy...

Edited May 23, 2011 by acozadd

[EMEDPA]

if you go md/do and do FP there is a lot of flexibility there as well as an easier than typical residency(only internship is tough, after that 50 hrs/week). an fp doc can do rural em, hospitalist, derm, ob(with sections if desired), minor surgical procedures(vasectomy, etc), colonoscopies/sigs, treadmills, concierge medicine, cruise ship or international medicine, etc

an fp doc from my em group just left to take a 20 hr/week job in which she can make her own hrs every week(2 tens or 2 eights and a 4 or 4 fives, etc) , no call, few weekends and no holidays doing walk in ambulatory care medicine with no permanent panel of pts(she sees overflow appts).

[coolbreeze]

I personally think PA vs. MD is an apples to oranges comparison. We need both of them and we need people to do both of them. Having a family when I'm still in my twenties is definitely a perk for me!! Likewise, having that title/ownership appeals to others. Of course, I am not denying the fact that MDs can't/don't plan on having families. Some of the family doctors I know seemed very rushed to have kids because obviously they were getting old and wanted to settle down a bit in professional life before having kids. Same goal, different views and paths.

[mktalon]

Lots of valid and interesting arguments to be made here. I am afraid, though, that some of you are missing the point. If you step back for a minute, just about every industry (business, law, education, etc.) places a premium on experience when evaluating potential candidates for a job. e.g., 2 candidates: one with 5 years of experience and one with <1 year - the nod will almost always go to the former candidate.

 

From my experience, the nod always goes to the person who knew somebody in H.R., no matter what their qualifications were! ; )

[gidget144]

I don't want to be a doctor for the following reasons:

 

1. I desire direct patient care without the crap that comes with being a doctor or nurse. (I know, PAs have their very own line of crap they take, but I see myself handling that. Also, I want to be hands-on, stitching people up, assisting surgery, injections, etc- with backup.)

2. I want to work, and want to learn to work right when I'm young. A career that starts in my late twenties does not thrill me. I'd be studying for 7+ years when I could have a career, travel, switch cities, meet people, make romantic mistakes, etc. I'd rather be a PA with five years of experience at age 27 than a doctor who has one year of residency experience.

3. I can start in internal medicine then move into sugery, ER, etc. I understand that changing specialties as a PA is not as easy as people make it seem, but it's certainly easier than trying to change specialties as a doctor.

4. I'm way more of a team player than a leader.

5. Most of the pre-med students I know are prestige chasers. That is not my style. They're also insufferable.

6. I am not putting myself into a quarter of a million dollars into debt because some old punk on a message board tells me so. (Yes, I'm aware PA school is expensive, but you're really not taking out any more than your expected starting salary, if you play your cards right.)

[marilynpac]

I don't want to be a doctor for the following reasons:

 

1. I desire direct patient care without the crap that comes with being a doctor or nurse. (I know, PAs have their very own line of crap they take, but I see myself handling that. Also, I want to be hands-on, stitching people up, assisting surgery, injections, etc- with backup.)

2. I want to work, and want to learn to work right when I'm young. A career that starts in my late twenties does not thrill me. I'd be studying for 7+ years when I could have a career, travel, switch cities, meet people, make romantic mistakes, etc. I'd rather be a PA with five years of experience at age 27 than a doctor who has one year of residency experience.

3. I can start in internal medicine then move into sugery, ER, etc. I understand that changing specialties as a PA is not as easy as people make it seem, but it's certainly easier than trying to change specialties as a doctor.

4. I'm way more of a team player than a leader.

5. Most of the pre-med students I know are prestige chasers. That is not my style. They're also insufferable.

6. I am not putting myself into a quarter of a million dollars into debt because some old punk on a message board tells me so. (Yes, I'm aware PA school is expensive, but you're really not taking out any more than your expected starting salary, if you play your cards right.)

 

 

Mobility is b/c more and more difficult, by the time you end your schooling don't be surprised anyone going into surgery as a career will have to have a residency first.

 

Also don't forget as a PA you are dependent, and with our lack of lobby that's going to stay that way for yrs to come. IOW you have to rely on someone to hire you, as a midlevel when times b/c tough you're the first to go, and the doc has to pick up the extra coverage with added hrs.

[hankea4]

From my experience, the nod always goes to the person who knew somebody in H.R., no matter what their qualifications were! ; )

 

mktalon: This is (sadly) true.

[marilynpac]

From my experience, the nod always goes to the person who knew somebody in H.R., no matter what their qualifications were! ; )

 

That's the way it is here in my Peyton Place....

[Firemedic13]

I don't want to be a doctor for the following reasons:

 

5. Most of the pre-med students I know are prestige chasers. That is not my style. They're also insufferable.

6. I am not putting myself into a quarter of a million dollars into debt because some old punk on a message board tells me so. (Yes, I'm aware PA school is expensive, but you're really not taking out any more than your expected starting salary, if you play your cards right.)

 

 

Re: #5- that is true.

Re: #6-:;-D::;-D::;-D::;-D::;-D: First off, I ain't that old. Second off a quarter of a million dollars IS your expected salary as an MD/DO.

 

As for the others I think people have pretty unrealistic notions of med school and residency. I know people who have had kids during both (she got her attendings to give her breast pump breaks while passing gas), have had romantic mistakes, have traveled (one woman I know spends two weeks with her daughter every summer in south america working at a clinic), etc. etc. etc. Is it longer than PA school? Yup. More arduous? Sure. Payoff at the end? Heck yeah.

 

Each path has it's own upsides, for sure. And some of what you listed includes those upsides. But I still think for most people in their early twenties going the PA route they are doing so because they think it is easier... as opposed to the older people applying who are doing this as an extension of their already outstanding career, hard work building on hard work.

 

ETA: Also, starting a family at 30 is not necessarily a bad thing. Seriously.

[deborah212]

1) PA is not an entry-level medical profession

The fact is that many PAs in the current decade have made this a first career. Perhaps not a first job; but a first career nonetheless. To say that PA is not an entry-level medical profession, I would think, is incorrect. You may not want it to be this way, but that does not change the reality that it can be. When I read these types of threads as a pre-PA student, I felt discouraged. As I read them now a PA, I do feel an element of disrespect. If a PA is not an entry level profession, yet I became a PA as a 1st career, what is the implication? Of course, this is your opinion and I assume not meant to be personal, but this is my interpretation. What if I were your preceptor on an inpatient medicine rotation. Would your feelings change? Maybe? Maybe not? Regardless, I know what I have to offer PA students and my PA colleagues despite my background.

 

2) HCE is not "paying your dues" or "checking a box"

It can be a means to an end. Some realize their endgame sooner.

 

3) PA is not for the young; they belong in medical school.

How can you judge/assume the personal reasons of every "young" pre-PA student of going to PA school? Maybe it is religious or family related.

 

4) PA is not a shortcut.

I wholeheartedly agree. That would degrade the value of my education.

 

5) If all PA programs respected points 1-4, there would be far less call for mandatory PA residencies and jobs seeking only PAs with 2+ years of experience.

I would wait until you start rotations until you make a statement like this. With the exception of the transition from paramedicine to emergency medicine, I'm unsure of how 5 years of working as an RN on med-surg or an EMT would prepare you for dermatology practice or the intricacies of vein harvesting. This is coming from only 3 years of PA experience, so there should be at least a grain of salt palated here. Being involved in a current hiring process, prior health care experience before PA school hasn't been discussed in deciding among candidates with the caveat of the necessity of some (less than a year considered)inpatient medicine experience as a PA.

 

I respect your opinion as I hope you do mine.

[rev ronin]

I respect your opinion as I hope you do mine.

 

I absolutely respect your opinion; your cases have been instructive and wildly helpful. I'm actually one week into my first rotation right now, and working alongside med students and interns in a teaching hospital, which gives me a couple of bits of perspective which probably didn't come out before:

1) Interns really do practice medicine in a really cool way, even while they're essentially dependent practitioners like PAs will always be.

2) PA rotations are not some walk-in-the-park compared to med student clerkships; in fact, we're treated essentially the same at this facility.

2) Thus, the gap between the paths (PA vs MD) is narrower than I originally thought.

 

Realize also that while I did say "the young ... belong in medical school", I never stuck an "all" on that. It's a generality, not an absolutism. I'd say there are a significant minority of under-25 people who are pre-PA who really do belong in PA school rather than medical school. Those are the ones who are self-assured enough that the opinion of a random Internet poster is not going to dissuade them. If I can save a few of the others the time and heartache of limiting themselves in a dependent role that they will outgrow about the time it no longer makes social or financial sense to go back to med school, then that's a good outcome.

 

The value of a year or two of specialty experience is obvious when one is being hired into a specialty, and that doesn't seem improper at all to me. The idea that a new grad needs a couple of years to get ready to serve in an FP capacity, however, concerns me. I suppose it could just be MDs who want to hire without having to train, but there's always the possibility that it's a reflection of declining PA quality and workforce readiness. There are plenty of things that make a good practitioner that aren't measured by the PANCE.

[deborah212]

Thank you for the thoughtful reply.

[gidget144]

I gotta say though, as a young'un, seeing people take PA as a shortcut to being a doctor or because they couldn't get into med school irks me because it downgrades the PA career as a whole. We can blame the AAPA for that, because they're not advocating the career well at all.

[Kayla2013]

this is a very interesting discussion but as someone in that age group (22) deciding to become a pa as a first career is just as much about academics and it is personal preference. i know i dont want to do research, something like 70% of med schools have over 90% of their matriculants completing some kind of research. it doesnt interest me, neither does taking 2 years of chem (gen chem is enough for me, maybe even a semester of bio/inorganic chem) and physics. i realized while having the internal debate i think we all have with ourselves that i really do just want to work, and go home.

there are exceptions to every rule but generally speaking, i like to be hands on and do as many hands on things as i can, learn alot (md or pa i believe this never [should] stop)

and make some good money while being able to "have a life" by that i mean travelling, EMEDPA listed some pretty nice government, out of the country jobs that appeal greatly to me, not to mention disaster relief.

I believe (possibly niavely) that i can do everything i want to do in medicine as a pa and that having a md/do isnt necessary.

[ChrsRcc]

I'm lost on the whole MD/PA issue, and can't seem to find my way. I'm a high school junior right now, and I'm starting to look at colleges. Obviously not a major issue right now, but still on my mind. I love medicine, and I want to help people through my work. I'm willing to put in the hard work, whether through medical school or PA school. Right now, here is what I now: I want to practice medicine, but I also want to marry at some point and raise a family. If my salary is just large enough to provide for myself and my future family, I'll be content. I don't need to be the top guy, as long as the patient receives the best care. The doctor title would be nice, but it isn't the most important thing to me. I don't know whether the large debt that comes with medical school will force me to live solely to work, and the future of healthcare isn't reassuring. Obviously, I sound like I'm siding with PA, but I'm pretty fair-sided right now. So, I can't decide between the two. I still have time, but I'm still worried on what the future will bring. If anyone has any advice, please let me know.

[Kayla2013]

Literally I was/am in your shoes and I'm not in a pa program so take this with a grain of salt but what helped me was really sitting down and thinking of what I wanted and didn't want. All outside things like money and kids and time spent in school aside what I at my core wanted.

Don't take this the wrong way because I've been there and I'm not much older than you but get some real life experience. Until a couple years ago I thought I wanted to be a nurse till I worked in the ER and that changes my mind dramatically.

Get out there and get your feet wet. Nit sure if u can be an EMT at your age but look in it. Also talk to people in both fields in different specialties and see how they feel about their life and career choices but remember it all comes down to you and what you can live with 20 years from now.

hope that helps

sorry for any typos I'm on my phone and aurocorrect is hit or miss

[Just Steve]

I'm lost on the whole MD/PA issue, and can't seem to find my way. I'm a high school junior right now, and I'm starting to look at colleges. Obviously not a major issue right now, but still on my mind. I love medicine, and I want to help people through my work. I'm willing to put in the hard work, whether through medical school or PA school. Right now, here is what I now: I want to practice medicine, but I also want to marry at some point and raise a family. If my salary is just large enough to provide for myself and my future family, I'll be content. I don't need to be the top guy, as long as the patient receives the best care. The doctor title would be nice, but it isn't the most important thing to me. I don't know whether the large debt that comes with medical school will force me to live solely to work, and the future of healthcare isn't reassuring. Obviously, I sound like I'm siding with PA, but I'm pretty fair-sided right now. So, I can't decide between the two. I still have time, but I'm still worried on what the future will bring. If anyone has any advice, please let me know.

 

PA school costs somewhere around 70-100,000. Average salary of a PA is about 85,000. Med school costs around 200,000-250,000. Average salary of a doc is around 200-250,000. The ratio of debt to salary is fairly close.

[delco714]

If it helps the age thing... I'm 21yo with my bachelors current great NY Masters PA program and just crushed my first full year! I will be a masters RPA-C at 23. Sounds good to me. I know for sure I made the right decision for ME. Enjoy my 20s, kids at 30, etc.

[Contrarian]

Nostalgia isn't what it used to be.

 

Change is inevitable, except from a vending machine.

 

Knowledge is knowing a tomato is a fruit; Wisdom is not putting it in a fruit salad.

 

"I thought I wanted a stable recession proof career, so I did the minimum required to get into and graduate PA school.

As it turns out, I really just wanted pay checks."

-anonymous PA

[HopefulPA]

1) PA is not an entry-level medical profession. It is a profession specifically crafted to take experienced providers and uplevel them. If you're not already an experienced entry-level (or higher) provider, you probably don't actually want to be a PA. You might think you want it, but how on earth can you know you want to see patients day in and day out if you've never seen a patient in your life?

 

Well I know I want to have children and I have never taken care of them day in and day out. But I do agree that PA is not entry level. Our decisions as a provider can have a profound impact on peoples lives. These must be made by mature individuals and while age does not equal maturity there is a high correlation.

 

2) HCE is not "paying your dues" or "checking a box".

and sometimes it is. I entered PA school at age 39, my previous experience was in business for nearly 20 years. I was sucessful and had been promoted to a executive director's postion for a billion dollar company. I learned how to deal with people, that things often don't go as planned, dealing with conflicting goals, working on multiple projects at a time and how to remove or get around road blocks to acheive the desired goals. Learning this CAN only come from experience. And this is what a good PA does! They can relate and work with folks from all walks of life and solve problems not how much HCE they have. I had about 1000 hrs of HCE as a home healthcare worker which was essentially babysitting for adults and I can't say that it has made one iota of a difference in my success as a PA. However the skills I learned in my previous career I utlize everyday! I got my pre-req (4.0 GPA) and nearly 4.0 PA school. I now work as a hospitalist PA covering private Attendings that may come 1 time a day to "see" their pt and are usually hard to reach by phone. This was my first job out of PA school, I had a whole 3 days of "training" before I was sent out on my own. I am coming up on 2 years, I have been told by the VP of Medical Affairs that my clinical skills are excellent. I often receive compliments from the Cheif of Medicine. I have also had to disagree with residents (who after I expalined why changed their recommendations)/ And most importantly I have had to sometimes disagree with my Attendings orders that would have potentially been dangerous to the pt. Being able to say no I can't do that to your boss without making them angry comes from my life's experience. So RevRon I agree experience is important but I don't think it necessarily needs to be HCE to be a good PA.

 

 

3) PA is not for the young; they belong in medical school. If you're under 25 and want to practice medicine, go to medical school.

 

I agree for the most part. If I could go back to when I was 20 something I would have gone to Medical School. Really if you are young and want to practice medicine then go to med school. You can have a life as a doctor, I am good friends with a Surgical Resident (who has 2 young children) so it can be done. As far as the money, once your done your salary will be about $200K and if you live with the same budget you did while in school/residency for one year that is a heck of allot of student loan payback! As a PA YOU will ALWAYS be caught in the middle which is one of the hardest places to be in any career. It comes with a heck of allot of grey areas and without life experience tough to deal with.

 

4) PA is not a shortcut. Agree. Our treatment plans can greatly affect people's lives.

 

5) If all PA programs respected points 1-4, there would be far less call for mandatory PA residencies and jobs seeking only PAs with 2+ years of experience..

 

Disagree but I do think that PA programs place too much importance on the how the number crunches. It isn't all about the GPA.

[acozadd]

PA school costs somewhere around 70-100,000. Average salary of a PA is about 85,000. Med school costs around 200,000-250,000. Average salary of a doc is around 200-250,000. The ratio of debt to salary is fairly close.

 

As a PA you just start making that salary much earlier...