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Give it to me straight.....

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For reference, here are my stats:

uGPA: 3.74, cum laude

sGPA: 3.5

GRE: No recent one


approx 300 hours so far with the school district volunteering in my kids' classrooms and such.

approx 50 hours as volunteer treasurer for my husband's FRG with the National Guard before deployment


approx 400 hours at the State House of Representatives;

  • Chairman of the Health Care Council
  • Performed bill tracking and analysis, legislative issue research, constituent services, maintained files, attended committee and council meetings, greeted clients and visitors

I've already got great shadowing and direct care volunteering set up starting in the spring.


It seems the more research I do, the further I dig myself into a hole.



The one thing I know for sure is that I want to be in medicine. My thousands of hours of being in the hospital as a patient or with my family members with cancer, etc... confirm this readily. I get elated thinking about holding a heart or delivering a baby. I had two natural child births and it was an amazing experience. I would do it for free. I know that I do not want to do nursing. I am interested in the medical model.



But then you get in the PA vs MD business and it gets tricky. My original plan has always been to go to med school. I had my two kids early and close together so that I would be in residency by this point and they would be in school most of the day. But, life had a different plan.


So, here I am. I will turn 29 in March and I know that I am young enough still to do either plan. For argument's sake, even though I have a bachelor's I still need science prereqs and healthcare experience for both. For my best shot at either PA or MD, I would apply in 2014 to start 2015. Putting me at 32 when I enter school. (Though there is a chance I could pull it off a year earlier.)

My oldest would be 11 and my youngest would be 10.



Moving is not an issue. We'd move wherever I got in. Obviously we'd have to move again probably for residency and then when I got a job, so that's one down side for me as I want to get stability for my kids. As much as I am a type A go getter, my kids and family are the most important to me. They've been through a lot and I want to do everything I can to make sure they have a wonderful life.



So here is where my thought pattern lies. Please be honest and let me know if I'm just being naive or any other helpful criticism :-)

PA advantages: Lateral mobility- I can change specialities if I like without having to go back to school. Decent pay. $80-$125k is probably ceiling. Malpractice seems to be included in most job offerings. I could go into OB/GYN and not have to worry about the astronomical cost of malpractice, even though only around 3% of PAs are in Ob/gyn. Not the bottom line, there is always someone else to turn to. As healthcare becomes increasingly more managed, providers will add more mid levels but that also means if they are paying MDs less, they will pay PAs less. More time with patients?


Disadvantages: Glass ceiling- There is nothing beyond where you are. You will always have an MD over you. Is this frustrating? You will always make a 1/3 of that new kid fresh out of residency when you have been on the floor for 20 years. Being given the call, night, weekend, holiday shifts that the MDs don't want. Doing the scut and paperwork that the MDs don't want. Always 1st assist in OR. Am I going to be working 60 hours a week for 1/3 of the money that MDs make working 40 hours/week? Though, I have seen job openings that are 40 hours/week, M-F, no weekends, etc...



MD advantages: You are your own boss. (hospital and insurance not withstanding). Set your own hours. No call or weekend if you don't want it. 12-15 shifts a month at $175avg/hour for EM. Partner track. The MD. Designing and carrying out the patient care plan. Actually performing the surgery.

Disadvantages: Amount of schooling time plus residency. Dealing with insurance and politics and paperwork.



Really, what scares me about the MD route is the amount of schooling and such. I want to be able to spend time with my family, help them with college and weddings (things I never got), enjoy time off with my husband, travel, etc...



I'll be 40 when my kids are grown. So plenty of time to practice, but I want to enjoy it and also be able to set myself up for retirement.



I do apologize for the length and thank you for your time.

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Give what to you straight? It reads to me that you have things well in your crosshairs with a very similar understanding to my own understanding of it all. I think you covered the bases pretty well...except you may be a little light in the EM pay for a MD...i believe they are a bit closer to the 300/hr range.


Is PA now, MD later an option worth considering?


Most PAs I talk to never report that their supervising doc is a pain in their backside. It has been my experience via conversations here in the northwest with PAs that they find a good doc with whom the bond well with and that doc is mostly a required signature, not a voice dictating their every move. These PAs are working sub 40 hour work weeks and making enough to enjoy the time they have off. When I ask them "can i work 30 hours a week and make 75K a year" they all say "easily". None of these PAs are doing scut work, pulling night shifts and holidays if they don't want to be.


Would being a MD be pretty cool? You betcha it would be. Would being a rad parent, making a decent salary with time off to spend it, who is involved in their kids lives while they grow up be pretty cool? You betcha it would be.


Which do you want more?

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Well only you can decide which path you want to choose. You seem to have done your research. It depends on where you are at in the pre-reqs. I did 1 year FullTime preqs and getting paid HCE then 2 yrs PA school. That is 3 years maybe 4 if you only do Pre-reqs and HCE part time.


You may also want to look into how all the new residency working rules have changed things. Before r/o PA vs MD. In fact I can tell you that during one of my rotations the med students had "rules" the chief resident had to follow, and one more than one occasion the medstudents had to leave and it was "That is OK the PA-student can stay there are no rules for PA hours" . It sucked but I knew that rotation was only a month long and I got more OR time than the 2 medstudents combined.

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