Dondoro88 Posted November 30, 2011 Share Posted November 30, 2011 I've noticed that a lot of PA schools are shifting to require almost 90% of the classes needed for medical school. I am taking my prereqs now and realized that by the time I'm done with prereqs for PA school, I would have everything done for med school too. My questions are: 1. With what you know now, if you were in my position, would you have gone for med school? I'll be 28 when I could start either program. 2. At what age would you have said MD is too late? 3. Everyone says the future for MDs is bleak and PAs is bright, would you agree? Any insight into the above would be appreciated. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted November 30, 2011 Moderator Share Posted November 30, 2011 1. yes. a big part of the reason I went to pa school was to avoid ochem and calculus. 2. 50 3. no, future is bright for both. Link to comment Share on other sites More sharing options...
Dondoro88 Posted November 30, 2011 Author Share Posted November 30, 2011 Thanks EMEDPA, what has been in your experience the main factor that made you think "I wish I'd done MD"? The PAs I've spoken to seem happy, while some say they do the physicians work for less pay. The flip side to this is that MDs have an extra 6 years of schooling - not sure how to justify monetary payoff for those extra 6 years Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted November 30, 2011 Moderator Share Posted November 30, 2011 it's not an extra 6 yrs of schooling it's an additional 2 yrs + 3 yrs of mandatory paid on the job training. I've been working in emergency medicine for 25 yrs. to have a good scope of practice I need to work nights in small depts or work in very rural areas. I won't even talk about the disrespect pa's have to put up with. an em physician 1 day out of residency has a better scope of practice that they can use anywhere, anytime without having to fight credentialling battles for every procedural skill and they make 3x my income for 2/3 as much work. that may sound bitter, but I have found ways to make this work for me. getting as much education as possible helps. working several jobs in different environments(rural, inner city, trauma ctr, overseas, disaster, etc) adds to the variety of experiences. today if starting over I would go to medschool without a doubt. as a new grad pa I would do a residency right out of school. it is the best way to prove you have skills and it can produce a procedural log that will shut up any credentialling troll. in my mid 40's I would still go to medschool (DO bridge program) if not for significant family issues preventing this. I'm still considering several options in the next few yrs. I am currently in a Doctorate program in health sciences & global health and when I am done with that I may work overseas, join the public health service, or do a residency. don't know. Link to comment Share on other sites More sharing options...
FfIghter23 Posted December 1, 2011 Share Posted December 1, 2011 Just to add my $0.02 about the "inferiority of PA's"... From evaluating the medical field the past few years, PA < MD in the sense that SOMEONE has to be the inferior being. 99% of MD's know good and well that PA's can do the job and do it well, but still want to limit PA's to being the "Assistant" that the name implies. I'm not saying a PA is an "equal" to an MD, because they aren't and not one PA will admit to that, but it is more about understanding the ROLE of a PA and utilizing them properly. Paramedics < Nurses in the eyes of most of the medical field, only because SOMEONE has to be the inferior being. Since EMS is a relatively new and constantly evolving field, no one really knows the scope of practice. Nurses have been around since the beginning of time (at least some of them look that way =) ) and so people know what Nurses do and ASSUME they are the greater being. Paramedics are not utilized in hospitals appropriately, at least not in the ones where I live. Paramedics get to wrap some gauze on a superficial wound and restock all the nurses supplies, because that is how paramedics are viewed here. Until those in the medical field drop ALL pride issues and understand the role of teamwork/collaboration/educating each other on roles and responsibilities, then it will be the same debates and the same problems arising again and again. Link to comment Share on other sites More sharing options...
HMtoPA Posted December 1, 2011 Share Posted December 1, 2011 it's not an extra 6 yrs of schooling it's an additional 2 yrs + 3 yrs of mandatory paid on the job training. 3 years is on the short end of a residency, isn't it? And if I understand it correctly, residencies are pretty brutal and one gets paid slave's wages. And of course you have to worry about matching first. In terms of schooling, it seems like many PA programs are pushing the 2 year timeframe - mine is 2 1/2, and I'm sure there are some 3 year programs out there by now (and of course PA schools don't break for summers). But I suspect that med school is more rigorous by several degrees - just a hunch, though. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted December 1, 2011 Moderator Share Posted December 1, 2011 there are a few 3 yr programs now, usc and others. 3 yrs for a residency gets you EM, FP, or IM. most everything else is longer. if I could step into a 3 yr residency right now and come out a boarded doc I would in a heartbeat, even taking into account the poor wages. I have made crap money before as an er tech and paramedic and could again. it's on the job training. most residents look back fondly on the time after it is done. internship is rough in any specialty but some programs get pretty cushy after that with call from home(or night float coverage for first call, etc). ms1 is brutal. ms 2/3 are similar to pa school, ms 4 is an extended vacation, residency interviews, and electives. one of my attendings spent most of ms 4 climbing in the himalayas with occassional stops at rural clinics and counted it as a cross cultural medicine rotation.... Link to comment Share on other sites More sharing options...
SocialMedicine Posted December 1, 2011 Share Posted December 1, 2011 I become a PA out of college. 3 years later I am very pleased with my decision. I work in an area of medicine with much "midlevel" autonomy. Had I desired a career in surgery I might not be as happy. If you are smart and optimistic you will make either work. If I went to medical school I bet I would be just as happy though. You gotta make what you have work for you. And a career which is exciting, challenging, and well paying like PA is easy for that. DO NOT BE FOOLED. Becoming a PA is a HUGE TIME committment if done right. As a new PA my hours in clinic were about 30 - 40 each week. However, being new to medicine, I would EASILY spend another 10 hours reading about patients each week. If you are not doing this, especially early on, you are not doing your job and will unlikely move into a autonomous role due to knowledge limitations . Every day I read for at least 30 minutes about something new, and usually a bit longer on the weekends. Medicine is very demanding, especially when you did not do a full residency and medical school. Link to comment Share on other sites More sharing options...
Dondoro88 Posted December 1, 2011 Author Share Posted December 1, 2011 I appreciate the discussion; been doing research on residency matching and how residency funding is being decreased. Seems appalling how someone could end up not matching or being matched in a specialty they don't want..eek Link to comment Share on other sites More sharing options...
aprillh Posted December 1, 2011 Share Posted December 1, 2011 If I had figured out earlier what I wanted to do with my life, I would have gone to Med school. No question. I was 28 when I started PA school. But I knew I wanted to have a career and family and going thru med school would have delayed that significantly. I have a great life now working 28 hrs a week in a specialty I love, time with my family, an amazing income... but I will always be an "assistant". And it doesn't matter how much I know or how long I have been practicing, to the lay person, I am just an assistant. Does it matter to me now? In my current job, not so much. My patients know me and respect me. I have earned a reputation of doing good work and people ask for me specifically, so that can be an ego boost. But if any of my children want to go into medicine, I would encourage them to go to med school. Link to comment Share on other sites More sharing options...
primadonna22274 Posted December 1, 2011 Share Posted December 1, 2011 E, you're not kidding about M1 being brutal. All the biochemical pathways and minutiae we skipped in PA school as "not practically important" is what I have to force myself to learn right now. Anything clinical I ace, but sadly exams are only 20-30% clinical now. But Path and Pharm are right around the corner...thank the Maker! And I really do think years 2-3 will be so much better. To the OP: I'm 37...actually nearing 38. I'm told I don't look it but I am feeling it a little bit lately. I started planning to return to med school at 28...yes, it has taken this long. For me the insensible desire had to reach a frenzy where it no longer mattered that it was a poor financial decision, that I was closer to 40, that I would be giving up autonomy for several years to later earn independence. My strong advice is that if you question at all whether you could be content as a dependent provider for the rest of your career, you should go to medical school. 28 is nothin'. But if you can embrace the role and become an outstanding PA, then go for it. My route is much more circuitous and expensive and I would never advise someone to go to PA school and try it out knowing they will likely go right on to med school...but we all make our choices. We could argue about the societal rights and wrongs of someone taking a spot from someone else who "really wanted to be a PA", but I don't play that game (much). Lisa Link to comment Share on other sites More sharing options...
physasst Posted December 1, 2011 Share Posted December 1, 2011 E, you're not kidding about M1 being brutal. All the biochemical pathways and minutiae we skipped in PA school as "not practically important" is what I have to force myself to learn right now. Anything clinical I ace, but sadly exams are only 20-30% clinical now. But Path and Pharm are right around the corner...thank the Maker! And I really do think years 2-3 will be so much better.To the OP: I'm 37...actually nearing 38. I'm told I don't look it but I am feeling it a little bit lately. I started planning to return to med school at 28...yes, it has taken this long. For me the insensible desire had to reach a frenzy where it no longer mattered that it was a poor financial decision, that I was closer to 40, that I would be giving up autonomy for several years to later earn independence. My strong advice is that if you question at all whether you could be content as a dependent provider for the rest of your career, you should go to medical school. 28 is nothin'. But if you can embrace the role and become an outstanding PA, then go for it. My route is much more circuitous and expensive and I would never advise someone to go to PA school and try it out knowing they will likely go right on to med school...but we all make our choices. We could argue about the societal rights and wrongs of someone taking a spot from someone else who "really wanted to be a PA", but I don't play that game (much). Lisa Lisa, you are right. You don't look it. I would have guessed no more than 29 or 30 when we met....(last year was it??? Time is slipping away) Link to comment Share on other sites More sharing options...
primadonna22274 Posted December 1, 2011 Share Posted December 1, 2011 Aw thanks Mike! But I must be slipping...3 years ago students thought I was 25. I have more wrinkles and white hairs than I had 6 mos ago for sure! Link to comment Share on other sites More sharing options...
crieman Posted December 1, 2011 Share Posted December 1, 2011 Three days ago one of our intensivists told me that I should've gone to medical school because I could "handle the information." She went on to say that PA's only do the scut work that MD's don't want to do and that I was capable of more. While she was trying to be complimentary I couldn't have felt more discouraged. I know not all docs see us this way but given the opportunity I would go back to school in a heartbeat. I completely agree with EMEDPA's posting. Here's a funny example of scope of practice; I had to do 45 central lines before I could apply for privileges. One of the hospitalists told me that she didn't even have to prove to them that she had done any and they automatically gave her privileges. She only did the minimum number of central lines in residency which was 3. She is admittedly scared to even try one now. I think the life of a PA is a constant battle for both respect and broadening one's scope of practice. Its not all negative though, this post may have just caught me in a bad week. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted December 1, 2011 Moderator Share Posted December 1, 2011 I think the life of a PA is a constant battle for both respect and broadening one's scope of practice. very true. I am still pushing against this. my solution has been to work where and when no one else wants to: rural/inner city/overseas and nights/weekends. it's paying off and I enjoy the work but I shouldn't have to fight this hard after this long for a good scope of practice and a bit of respect. Link to comment Share on other sites More sharing options...
ohiovolffemtp Posted December 2, 2011 Share Posted December 2, 2011 1. Yes, MD or DO school. The DO schools I looked into required fewer pre-reqs (no entire year of A&P, less psyche, etc) that the PA schools I looked into. 2. 45 - I'm way beyond that, so it's PA school for me. 3. Lots of jobs for both - maybe not ideal - but better than in IT or FF/medic - my past 2 careers. Link to comment Share on other sites More sharing options...
Dondoro88 Posted December 2, 2011 Author Share Posted December 2, 2011 I've been looking at DO curriculums; I like how they have one year of GP but it seems residency/specialization is harder this way Link to comment Share on other sites More sharing options...
winterallsummer Posted December 2, 2011 Share Posted December 2, 2011 I'm entering in 2012 and took all the pre-reqs for med school (and even some nasty stuff like genetics). I don't even comprehend how not taking a pre-req would limit someone from MD rather than PA. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted December 3, 2011 Moderator Share Posted December 3, 2011 I've been looking at DO curriculums; I like how they have one year of GP but it seems residency/specialization is harder this way it's actually easier as you can apply to both DO or MD residencies and fellowships and MD can only apply MD. Link to comment Share on other sites More sharing options...
jazzyjoker Posted December 3, 2011 Share Posted December 3, 2011 This has been a really interesting discussion. Something really interesting came on the news a couple of days ago here. Apparently LSU medical center has decided to do a distance type program here in my city with a 3 year MD program for people wanting to practice in IM, Family practice type of stuff in a mostly rural environment. I have been accepted to PA school, but this looks incredibly appealing. I'd be looking at difference of 9 months to have an MD with most likely 3 years of residency tacked on. If only this would have been offered a year ago, I'd be studying my butt off to retake the MCAT (been out of school about 7 years). I would hate to give up a sure thing spot in a class at a good school for something that I might not even get into. I do think this is the most positive thing that Louisiana has done for healthcare in a while. Here's a link if you'd like to see more: http://www.theadvertiser.com/article/20111201/NEWS01/111201008/UL-partners-LSU-med-school-3-year-MD-program?odyssey=nav|head Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted December 3, 2011 Moderator Share Posted December 3, 2011 nice. there is also a 3 yr primary track at lecom and a 3 yr primary care track in TX. Link to comment Share on other sites More sharing options...
HopefulPA Posted December 3, 2011 Share Posted December 3, 2011 If I was in my 20s again I definately do the MD/DO over PA. Yeah there is the whole residency but it is paid, peanuts yes but enough to survive on. compared to the life time a higher income and autonomy , yes I will do it again. My co-worker did PA school in her 20s and she has been working for about 8 years. She just said the other day she wishes she would have went to med school she is tired of all the scut. Link to comment Share on other sites More sharing options...
Cideous Posted December 3, 2011 Share Posted December 3, 2011 Wow you guys complain a lot. I've been a PA for 17 years and would not change a thing. I have several close friends who are docs and most of them are MISERABLE. Huge school debt, crappy salaries, terrible liability blah blah blah. For you younger guys wondering what to do, go spend a month with a family practice doc OR better yet, go watch the documentary "The Vanishing Oath" and then come back and tell me how great being a doc is. btw, the guy that made The Vanishing Oath was an ER doc.......... Being a PA is great. Best return to investment <time money> you can do. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted December 3, 2011 Moderator Share Posted December 3, 2011 the docs I know( mostly em ) work 2/3 as much as I do for significantly more money, always take great vacations, get perks of being a doc such as better parking, partnership bonuses(based on MY productivity), shorter shifts, more professional respect from staff and patients, etc sure, being a pa is great. better than 90% of the jobs out there. being a doc in terms of lifestyle is better. Link to comment Share on other sites More sharing options...
physasst Posted December 3, 2011 Share Posted December 3, 2011 Wow you guys complain a lot. I've been a PA for 17 years and would not change a thing. I have several close friends who are docs and most of them are MISERABLE. Huge school debt, crappy salaries, terrible liability blah blah blah. For you younger guys wondering what to do, go spend a month with a family practice doc OR better yet, go watch the documentary "The Vanishing Oath" and then come back and tell me how great being a doc is. btw, the guy that made The Vanishing Oath was an ER doc.......... Being a PA is great. Best return to investment <time money> you can do. Just for clarification, the huge school debt seems to be a growing issue for many PA's as well. I graduated many years ago as well, and without much in the way of student loan debt, but many newly graduating PA's are NOT in the same situation. Link to comment Share on other sites More sharing options...
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