startingover Posted November 3, 2011 Share Posted November 3, 2011 Hi everyone, I graduated a US Med school in 2010, now 2 years into residency but am having serious doubts about my profession (radiology) and am looking into to other career options, medical and otherwise. What prompted my thought about this was having had a shave biopsy this morning by a PA who makes 100K+ at a Derm office. I would strip myself of the title 'doctor' and the MD from my badge, and take on this job TOMORROW if it were hypothetically offered to me...in all sincerity. I think it's a great, balanced way to earn a living. A few questions if someone out there happens to be generous enough with their time to answer. 1) Is there any precedent for an MD acquiring PA licensure? For instance, the NCCPA website states that you have to have graduated from an accredited PA school to sit for PANCE. By default, I'm assuming that statement includes someone with an MD but I also my situation is maybe an exceedingly rare one. 2) Another question out of ignorance, but I noticed some forums about residencies. Is this required of PAs or just an option? I was under the impression that upon graduating (27 months?) you are employable. 3) What exactly are the requirement for employment? Does it vary on a state by state basis, or on an employer by employer basis? I noticed there are PAs and PA-Cs... but unless I'm mistaken you can't get a state licensure unless you are PA-C. And to bring it full circle, do employer sometimes/often/always require state licensure before hiring? 4) What are the competitive specialties that PAs go into these days? Thank you so much to the kind soul who doesn't mind answering. Link to comment Share on other sites More sharing options...
nebero Posted November 4, 2011 Share Posted November 4, 2011 Don't make sense to me. If what impressed you is the PA doing derm you should try to get in to derm as an MD and you will be doing even more. I just don't understand why you want to take a step back. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted November 4, 2011 Moderator Share Posted November 4, 2011 you would need to apply to and complete an entire pa program to be eligible to sit for pance. it is highly unlikely(and I say this as a former adcom member) that any pa program would accept a physician who already has a license to practice medicine. it would be a waste of a valuable spot. at this point as a second yr resident you already have a license to practice. you could go work urgent care as an md tomorrow and make 150 dollars/hr without finishing your residency. if you are that miserable with rads switch to something else or maybe do IR for more hands on. Link to comment Share on other sites More sharing options...
primadonna22274 Posted November 4, 2011 Share Posted November 4, 2011 Agree with E. Former PA faculty here, 2 (very different) adcoms... only time either of them would consider admitting a physician would be an FMG who did NOT have a US license and for whom retraining in the US would be a very expensive burden. How long is rads residency--4 yr? 5? What is it that you don't like about it? Have you considered swapping for a different residency? I know you would likely lose time but would not incur further education expense except for opportunity costs. Don't underestimate the difficulty of dropping your "doctor"-ness. You are trained as an independent provider. PAs have varying degrees of autonomy but are never independent. This really got to me after about 35 when so many of my attending physicians were getting younger than me and had been out of high school less time than I had been practicing medicine. Bit the bullet and am now a happy (yes overwhelmed, yes poorer, yes older than most of my classmates) DO student. Unless disaster struck I would not return to PA practice once embarking on this path. I think you'll find that becoming a PA is not a reasonable option for you, but I do hope you will find some niche in medicine that you can enjoy. Maybe you need more patient interaction? Good luck.... Link to comment Share on other sites More sharing options...
JCrownover Posted November 4, 2011 Share Posted November 4, 2011 It would make more sense to obtain a M.D. residency in a more desirable specialty if you are unhappy where you are now. Even if you could become a PA, you'd have the expense of PA school before you could sit for the PANCE. No, PA residencies are not required. In some instances they are very desirable though - and make it easier to break into a field that you have no previous work experience in. PAs are employable out of PA school (most all instances require that they've become certified). Each state and employer will have their own particular set of rules and hoops you have to jump through. With that said, some employers wouldn't hire a new grad without a residency or previous experience. Link to comment Share on other sites More sharing options...
Contrarian Posted November 4, 2011 Share Posted November 4, 2011 Also... Consider that some states will NOT even consider licensing someone as a PA who completed MD/DO school. These states have laws that state if you have EVER completed a MD/DO program, you are in-eligible/disqualified for a PA license. YMMV Contrarian Link to comment Share on other sites More sharing options...
JCrownover Posted November 4, 2011 Share Posted November 4, 2011 Also... Consider that some states will NOT even consider licensing someone as a PA who completed MD/DO school. These states have laws that state if you have EVER completed a MD/DO program, you are in-eligible/disqualified for a PA license. Hm. Why is this? Link to comment Share on other sites More sharing options...
Beorp Posted November 4, 2011 Share Posted November 4, 2011 I think it's a great, balanced way to earn a living. For some reason, this comment jumped out at me. What exactly do you mean by your impression that being a PA is a "balanced" way to earn a living? Link to comment Share on other sites More sharing options...
Administrator rev ronin Posted November 4, 2011 Administrator Share Posted November 4, 2011 Look, you've made it through your internship year, you've presumably got your medical license. You could quit residency, be a GP, and then go SUPERVISE PAs for a living. Link to comment Share on other sites More sharing options...
haeriphos Posted November 12, 2011 Share Posted November 12, 2011 Hm. Why is this? If I had to guess, it's because the mindset of an independent provider is different than that of a dependent provider. As a PA you have to have a good working relationship with your SP and know the limits of your scope. That might be a hard transition to make for an MD that is used to having the ability to practice independently. Link to comment Share on other sites More sharing options...
SocialMedicine Posted November 12, 2011 Share Posted November 12, 2011 plenty of PAs (outpatient mostly) enjoy essentially indep practice. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted November 12, 2011 Moderator Share Posted November 12, 2011 plenty of PAs (outpatient mostly) enjoy essentially indep practice. And rural/small dept em....... at my primary job I rarely see or work with my sp. we communicate via email and messages in my box. Link to comment Share on other sites More sharing options...
cbrsmurf Posted November 13, 2011 Share Posted November 13, 2011 Derm is one of the most difficult specialities to get into as a doc; much easier to get into derm if one were a PA... Link to comment Share on other sites More sharing options...
mackjacks Posted November 13, 2011 Share Posted November 13, 2011 To give some answer to the OPs third question: A PA-C is certified, meaning they have passed the national certifying exam. This qualifies them for State licensure. Certifying must be done by passing the PANCE after graduating PA school. So you are correct that in order to obtain an initial State license, a PA must be a certified PA-C. To keep the C, a PA must re-certify every 6 years, otherwise they can only call themselves a PA. Some employers require PAs to maintain certification, others allow their PAs to drop it (example, a PA mother of 4 that I know who works 2 days/ week in her DO husband's office). I remember reading something about in certain states (Illinois?) the supervision requirements of a PA and PA-C are different and the PA-Cs can be more autonomous. Hope this helps! I'd stay a MD if I were you...you've already likely invested so much $ in your education. Based on your post, I have concluded that you might have though you could take the PANCE tomorrow and start working as a PA in the span of a few months? Link to comment Share on other sites More sharing options...
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