Is med school actually harder?

[Reality Check 2]

Sorry I had your hours wrong!

I couldn't handle 200.

Don't know how you do it!

[PACdan]

I'll give another example of something that really bothered me as a PA. I worked with a PA who was practicing for around 35yrs. His "boss" and supervising physician was fresh out of residency, and also about half the age as the PA. This PA was very, very intelligent and knew his stuff, he's been working in this specialty for 35 years. He was treated like garbage by this new physician. He would be presenting a case to the doctor in front of a room of physicians/students/nurses, and the new doctor stopped him mid-sentence and said, "Whoever taught you how to present a patient had no idea what they were doing? " He then went on a rant about how he wanted patient's presented to him, exactly what he wanted, in which order. Not to mention his salary was 3x the PA. Also, many times in the office I would hear patient's say they want to see the doctor, not a PA. So just because of his title, all of the PA's years of hard work and expertise were dismissed, because "he's only a PA." Unfortunately, these examples with patients happens frequently. Also, this new physician has complete control over his schedule/vacation, his office/patient schedule, etc. They come and go when they please, and no one can do anything about it. Unfortunately, as a PA, no matter how much you may actually know, and no matter how competent and intelligent you are, you will never get the respect from patient's and physicians that you deserve. That gets old real quick. Sorry for the rant. 

 

 

Why was a "35-year" veteran PA presenting anything to anyone? All I've ever seen is younger docs eagerly consulting seasoned, veteran PAs. I usually see older PAs and docs consulting with each other. In multiple practices, at various locales. Why was a "fresh out of residency" doc his SP anyway? Was there no one else in the practice, no older docs?

 

My response would have been "Whoever taught you manners had no idea what they were doing." Places usually don't put up with young-bloods acting like that, no matter what your suffix is. And if you're going to make it like the PA always has to be some MD's whipping boy, either that PA had no spine/clout or the practice is toxic beyond belief.

[EMEDPA]

Sorry I had your hours wrong!

I couldn't handle 200.

Don't know how you do it!

variety...and long shifts...and places with high acuity/low volume....this month I am at a conference for a week and still have 197 hrs...

[Hckyplyr]

Why was a "35-year" veteran PA presenting anything to anyone? All I've ever seen is younger docs eagerly consulting seasoned, veteran PAs. I usually see older PAs and docs consulting with each other. In multiple practices, at various locales. Why was a "fresh out of residency" doc his SP anyway? Was there no one else in the practice, no older docs?

 

My response would have been "Whoever taught you manners had no idea what they were doing." Places usually don't put up with young-bloods acting like that, no matter what your suffix is. And if you're going to make it like the PA always has to be some MD's whipping boy, either that PA had no spine/clout or the practice is toxic beyond belief.

 

I guess I should have specified more, in this particular speciality, we were the consult service in the hospital. So, every....single...patient had to be presented to the doctor, then the physician makes the decision on treatment/surgery/etc. Physician was straight out of fellowship, obviously knows his stuff. There were multiple doctors in the group, which means each one is essentially your boss, they had the final say, always. I realize this isn't the case in a lot of jobs, but was in my case in particular, which was just more ammo for me to go back to school. 

[PACdan]

I guess I should have specified more, in this particular speciality, we were the consult service in the hospital. So, every....single...patient had to be presented to the doctor, then the physician makes the decision on treatment/surgery/etc. Physician was straight out of fellowship, obviously knows his stuff. There were multiple doctors in the group, which means each one is essentially your boss, they had the final say, always. I realize this isn't the case in a lot of jobs, but was in my case in particular, which was just more ammo for me to go back to school. 

 

Undoubtedly your experience after school (I am assuming to be singular, i.e. one job) shaped your worldview of the profession. However, there are many places where PAs are not treated as such.

 

There was a horrible Kevin MD article written by a PA-cum-Med Student late last year, in which she claimed to have "hit the ceiling" as a PA after roughly a year, prompting her return to medical school. Hers tended to imply that she couldn't learn anymore as a PA, which is laughable. Clearly ego was involved, and to me that's such a superficial reason to go to medical school. Every time I see a post by an experienced PA here or elsewhere that talks about going or wanting to go to medical school it usually centers around 1) They have truly maxed out their scope (over multiple jobs and years), and while their fund of knowledge is extensive, the PA initials are holding them back AND/OR 2) They are tired of the bureaucratic headaches and artificial constraints placed on them as a PA.

[Acebecker]

Hckyplyr -

 

As you state that comparing some PA programs to MD programs is a farce, so is comparing your single experience of the PA profession with regard to respect and the methods in which we practice.  Sounds like that doc was an arrogant prick.  That doesn't incentivize me to go to medical school.  I am treated as a peer in my practices.  I'll admit that there were rocky times when I was first out of school - nurses questioned me and I set them straight, doctors called when I took care of their wounded patients and didn't understand why I had done some of the things I had done and felt they could question my methods and I set them straight as well. But as I have been present in the community for more and more time, there is respect from my colleagues - MDs, DOs, PAs, and NPs as well as our nursing staffs - and nothing less. 

 

I guess if you want instant respect (even though it is not deserved) going to medical school may be the way to go.  I am content to build my reputation and the respect that goes with that. 

 

With regard to medical school vs. PA school being harder....  I don't know.  Without knowing what kind of program you went to (the program's reputation and their academic calendar) I can't tell you a lot about your experience.  My experience was from a top 10 PA school (at that time) affiliated with a very well known regional medical school (University of Washington).  I have since taught first year medical students in that program and their academics, while very rigorous, were not as intense as the PA program.  Don't get me wrong....  I'm not saying UW medicine is easy.  Nor am I saying we learned histology, embryology, etc. the same as the 1st and 2nd year med students.  I'm saying that the rate and intensity of the PA program tops the MD program. 

 

You can say that my experience is anecdotal.  It is.  Yet here we have several PAs who are familiar with the concurrent MD programs at their schools saying that the PA program was more intense.  I think that generalizing anything about this is difficult - I would bet that some programs that are not affiliated with medical centers and thus do not have as much of a rigorous backbone to build off of would be easier than medical school - maybe even a cake walk by comparison.  My program (and I would really hope most programs are more similar to mine rather tan dissimilar) was not that way.  If that intensity of training is not the training you got, you should have gone back to medical school. 

[Hckyplyr]

Hckyplyr -

 

As you state that comparing some PA programs to MD programs is a farce, so is comparing your single experience of the PA profession with regard to respect and the methods in which we practice.  Sounds like that doc was an arrogant prick.  That doesn't incentivize me to go to medical school.  I am treated as a peer in my practices.  I'll admit that there were rocky times when I was first out of school - nurses questioned me and I set them straight, doctors called when I took care of their wounded patients and didn't understand why I had done some of the things I had done and felt they could question my methods and I set them straight as well. But as I have been present in the community for more and more time, there is respect from my colleagues - MDs, DOs, PAs, and NPs as well as our nursing staffs - and nothing less. 

 

I guess if you want instant respect (even though it is not deserved) going to medical school may be the way to go.  I am content to build my reputation and the respect that goes with that. 

 

With regard to medical school vs. PA school being harder....  I don't know.  Without knowing what kind of program you went to (the program's reputation and their academic calendar) I can't tell you a lot about your experience.  My experience was from a top 10 PA school (at that time) affiliated with a very well known regional medical school (University of Washington).  I have since taught first year medical students in that program and their academics, while very rigorous, were not as intense as the PA program.  Don't get me wrong....  I'm not saying UW medicine is easy.  Nor am I saying we learned histology, embryology, etc. the same as the 1st and 2nd year med students.  I'm saying that the rate and intensity of the PA program tops the MD program. 

 

You can say that my experience is anecdotal.  It is.  Yet here we have several PAs who are familiar with the concurrent MD programs at their schools saying that the PA program was more intense.  I think that generalizing anything about this is difficult - I would bet that some programs that are not affiliated with medical centers and thus do not have as much of a rigorous backbone to build off of would be easier than medical school - maybe even a cake walk by comparison.  My program - and I would really hope most programs - are not that way.  If that's the training you got, you should have gone back to medical school. 

 

I said that my experience was "added ammo to go back to school," it was definitely not the main reason. I have several reasons that were much more important to me. So I wanted to get that straight. My program training was just fine, I did great on my boards. Also, I don't know how "teaching first year medical students" a course or two would give you the confidence to say its not as intense as the PA program. What courses are you teaching btw? We have all MD/DO and PhD's teaching ours, but mostly all PhDs. There's a huge difference between actually going through medical school, and teaching a course to first year students, for you to make those assumptions. Individual instructors have no idea what our schedules are like.

 

These threads are funny, people are asking if medical school is harder than PA school, and asking for the opinion of people who actually went through both, then when I give my opinion, people who haven't went through both disagree and say otherwise.  

   I will agree with you on a few things. That doctor was a prick, my experience was not typical for all PAs, and everyones opinions are subjective.

[Acebecker]

Solid point about the humor of the thread.  You have gone through both, I have not.  That said, when your singular experience contradicts what I have experienced and seen and heard - even if my experience is not the exact same as yours, I question it and I want to discuss it, that's all. 

 

As far as teaching/precepting - I have gotten to know some of the students well and the intensity of their coursework has been a topic of discussion.  I'll leave it at that. 

 

And...  I'm throwing this out - do you suppose that we may be comparing apples to oranges to a certain degree?  While we can say that we are all trained in the medical model (apples to apples) the content of our training is different (apples to oranges) as is the duration (apples to oranges again).  It would seem, perhaps, that each is very difficult in its own way. 

 

That sounds like a total cop-out, doesn't it? 

[delco714]

Hckyplyr -

 

As you state that comparing some PA programs to MD programs is a farce, so is comparing your single experience of the PA profession with regard to respect and the methods in which we practice. Sounds like that doc was an arrogant prick. That doesn't incentivize me to go to medical school. I am treated as a peer in my practices. I'll admit that there were rocky times when I was first out of school - nurses questioned me and I set them straight, doctors called when I took care of their wounded patients and didn't understand why I had done some of the things I had done and felt they could question my methods and I set them straight as well. But as I have been present in the community for more and more time, there is respect from my colleagues - MDs, DOs, PAs, and NPs as well as our nursing staffs - and nothing less.

 

I guess if you want instant respect (even though it is not deserved) going to medical school may be the way to go. I am content to build my reputation and the respect that goes with that.

 

With regard to medical school vs. PA school being harder.... I don't know. Without knowing what kind of program you went to (the program's reputation and their academic calendar) I can't tell you a lot about your experience. My experience was from a top 10 PA school (at that time) affiliated with a very well known regional medical school (University of Washington). I have since taught first year medical students in that program and their academics, while very rigorous, were not as intense as the PA program. Don't get me wrong.... I'm not saying UW medicine is easy. Nor am I saying we learned histology, embryology, etc. the same as the 1st and 2nd year med students. I'm saying that the rate and intensity of the PA program tops the MD program.

 

You can say that my experience is anecdotal. It is. Yet here we have several PAs who are familiar with the concurrent MD programs at their schools saying that the PA program was more intense. I think that generalizing anything about this is difficult - I would bet that some programs that are not affiliated with medical centers and thus do not have as much of a rigorous backbone to build off of would be easier than medical school - maybe even a cake walk by comparison. My program (and I would really hope most programs are more similar to mine rather tan dissimilar) was not that way. If that intensity of training is not the training you got, you should have gone back to medical school.

I run our inpatient service alone while the docs are on call alternating during the week. They wouldn't stutter to agree. They come and go but I'm the anchor of the practice. Just how it is. I saw a cardiologist verbally crapping on his np a few weeks ago about her exam/assessment to her face. I just sat there staring not realizing wtf was going on.. Disrespectful physicians exist. I haven't wanted to go to md school yet. Who knows what the future brings. What I do know now that I didn't in the past, is I would be every bit if not more so successful than my M.D.colleagues had I chosen that path.

[Reality Check 2]

And, to borrow from another couple of threads.

 

Press/Ganey sucks for all - whether MD/DO or PA.

 

So, no matter where you go to school or your title - the admins will get you in the end - quite literally.....

[Gordon, PA-C]

I run our inpatient service alone while the docs are on call alternating during the week. They wouldn't stutter to agree. They come and go but I'm the anchor of the practice. Just how it is. I saw a cardiologist verbally crapping on his np a few weeks ago about her exam/assessment to her face. I just sat there staring not realizing wtf was going on.. Disrespectful physicians exist. I haven't wanted to go to md school yet. Who knows what the future brings. What I do know now that I didn't in the past, is I would be every bit if not more so successful than my M.D.colleagues had I chosen that path.

 

I basically run the pediatric cardiothoracic surgery unit at our hospital.  I decide who gets surgery and when they get surgery, and I manage all the complications with minimal input from the attendings.  I'm a better surgeon than many of the "surgeons" who are my "supervisors."  

 

PAs are in many respects superior to MDs.  MDs spend way too much time in school memorizing shit that doesn't matter to clinical medicine.  Sure, they know more about the Kreb's cycle than I do, but I run circles around them when it comes to cardiac pathophysiology.

[PAtoB]

You're not really done, though.  You'll spend two years frantically pounding Up To Date and hell, maybe you'll do a residency, too.

 

yeah, but you'll be making range of $90ishK-$125ishK  as you do so - without med school loan debt - compared to what ... $48K-58Kish during those residency years?

[Hckyplyr]

I basically run the pediatric cardiothoracic surgery unit at our hospital.  I decide who gets surgery and when they get surgery, and I manage all the complications with minimal input from the attendings.  I'm a better surgeon than many of the "surgeons" who are my "supervisors."  

 

PAs are in many respects superior to MDs.  MDs spend way too much time in school memorizing shit that doesn't matter to clinical medicine.  Sure, they know more about the Kreb's cycle than I do, but I run circles around them when it comes to cardiac pathophysiology.

 

You are so delirious, unless your entire post was meant to be a joke, then never mind. 

[Hckyplyr]

yeah, but you'll be making range of $90ishK-$125ishK  as you do so - without med school loan debt - compared to what ... $48K-58Kish during those residency years?

 

Why is everyone so shortsighted. Yes, a new grad PA makes more than a resident, but over the long run, and shortly after residency, the physician will surpass the PA significantly, and make much more in lifetime earnings. So what does it matter if they PA gets a head start for 2-3 years? 

[Michaelcohn]

Why is everyone so shortsighted. Yes, a new grad PA makes more than a resident, but over the long run, and shortly after residency, the physician will surpass the PA significantly, and make much more in lifetime earnings. So what does it matter if they PA gets a head start for 2-3 years? 

 

Im trying to figure this one out, but its not just 2-3 years. If someone starts both med n pa at age 24. As a PA there done at age 26 and make ~100k w/ -100k in debt. As a doc they get to -250k debt by age 29 then make ~50k for 3 years. If the doc makes ~200k then by about age 40 they would equal the PA in salary. After age 40 obviously the doc gets farther and farther ahead.

[Timon]

Im trying to figure this one out, but its not just 2-3 years. If someone starts both med n pa at age 24. As a PA there done at age 26 and make ~100k w/ -100k in debt. As a doc they get to -250k debt by age 29 then make ~50k for 3 years. If the doc makes ~200k then by about age 40 they would equal the PA in salary. After age 40 obviously the doc gets farther and farther ahead.

This was my deciding factor to go PA school over Med school. I had done an analysis on excel and forecasted estimated debt over time compared to income and concluded it would take 14 years for a break even point between the two pathways starting from day 1 of PA school vs day 1 of med school. I was 32 when I applied for PA school, starting at 33 years old with estimating graduating PA school when I turn 36. That would mean that I would be 47 before I made money to recuperate my losses and started making money that exponentially dwarfed the salary I'd make as a PA.

 

However, being married with kids in my 30s, I needed to sustain a living with very little downtime versus had I been younger or even without any wife or kids, then med school would have been the obvious choice. But I wanted to start my life in my 30's instead of when I was in my late 40's. IMO, if you're young without any ties or obligations, you should ask yourself "why am I it going to med school?" Because honestly, that's the question I always ask to myself when I see people applying for PA school that have no kids and are younger than 26...

[PACdan]

I basically run the pediatric cardiothoracic surgery unit at our hospital.  I decide who gets surgery and when they get surgery, and I manage all the complications with minimal input from the attendings.  I'm a better surgeon than many of the "surgeons" who are my "supervisors."  

 

PAs are in many respects superior to MDs.  MDs spend way too much time in school memorizing shit that doesn't matter to clinical medicine.  Sure, they know more about the Kreb's cycle than I do, but I run circles around them when it comes to cardiac pathophysiology.

 

Okay, slow down there Alec Baldwin. I'm quite sure the CT surgeons who spent a minimum of 6 years, usually 7, between gen surg residency + CT fellowship, know their stuff. Let's not belittle that training.

 

 

Why is everyone so shortsighted. Yes, a new grad PA makes more than a resident, but over the long run, and shortly after residency, the physician will surpass the PA significantly, and make much more in lifetime earnings. So what does it matter if they PA gets a head start for 2-3 years? 

 

I don't think it's shortsightedness. Not everyone wants to be an MD. Some of us want to spend our careers, dare I say a majority, as PAs. I chose this pathway, after careful consideration. I think because of the the way our system of medicine is structured, in a way like a militaristic hierarchy, people assume that being on the top is the ultimate goal. Maybe every Colonel wants to be a General, I don't know, I was never in the Armed Forces. But in terms of medicine, I can do exactly what I want (primary care) as a PA. In fact, it looked like the best choice over MD/DO for me. So when someone says, "here's a benefit OF becoming a PA", it's not always that they could ultimately make more money as a doc, it's just a perk of that pathway all things considered. If I wanted to make "more money" I could have done something other than medicine and made more than a doc or PA. It's not a purely financial decision, but as Timon points out below, it is a factor.

 

This was my deciding factor to go PA school over Med school. I had done an analysis on excel and forecasted estimated debt over time compared to income and concluded it would take 14 years for a break even point between the two pathways starting from day 1 of PA school vs day 1 of med school. I was 32 when I applied for PA school, starting at 33 years old with estimating graduating PA school when I turn 36. That would mean that I would be 47 before I made money to recuperate my losses and started making money that exponentially dwarfed the salary I'd make as a PA.

 

However, being married with kids in my 30s, I needed to sustain a living with very little downtime versus had I been younger or even without any wife or kids, then med school would have been the obvious choice. But I wanted to start my life in my 30's instead of when I was in my late 40's. IMO, if you're young without any ties or obligations, you should ask yourself "why am I it going to med school?" Because honestly, that's the question I always ask to myself when I see people applying for PA school that have no kids and are younger than 26...

 

 

Yup, this is very succinct. Based on my age, what I wanted to do, and how long it would take to get there, PA made more sense. Among other deciding factors, it was the better choice for me as well.

[PA2B2017]

And, to borrow from another couple of threads.

 

Press/Ganey sucks for all - whether MD/DO or PA.

 

So, no matter where you go to school or your title - the admins will get you in the end - quite literally.....

ah, yes, the buttocks again! LOL! Still snickering ...

[Hckyplyr]

Im trying to figure this one out, but its not just 2-3 years. If someone starts both med n pa at age 24. As a PA there done at age 26 and make ~100k w/ -100k in debt. As a doc they get to -250k debt by age 29 then make ~50k for 3 years. If the doc makes ~200k then by about age 40 they would equal the PA in salary. After age 40 obviously the doc gets farther and farther ahead.

 

Your math is wrong. I will do a simple generalized calculation for you. Starting both at age 26. I will take the high end of the PA salary (because you likely won't start at $100k, and the low end of the physician salary (FM physicians average $207k a year, see my link provided above)

Finish PA at age 26: $100k/yr x 14 years. Age 40, you've made $1.4 million

Finish Med school age 28: 3 yrs residency at $50k, 9 years at $207k. Age 40, you've made a bit over $2 million. 

$2 million - $1.4 million= $600/000 difference by age 40. Your break even is age 37, not 40.......You could have more med school debt, I don't though. Depends where you go to school.  Also, we are taking THE LOWEST PAID physician salary here. Take specialty salaries its the break even is much, much sooner and the lifetime earning will be much more. All I'm saying is that if you're going to PA school because the schooling is shorter, you think you will have less debt, but your end goal is to take care of patients and be an excellent clinician, you are making a big mistake and will likely regret it. 

 

This was my deciding factor to go PA school over Med school. I had done an analysis on excel and forecasted estimated debt over time compared to income and concluded it would take 14 years for a break even point between the two pathways starting from day 1 of PA school vs day 1 of med school. I was 32 when I applied for PA school, starting at 33 years old with estimating graduating PA school when I turn 36. That would mean that I would be 47 before I made money to recuperate my losses and started making money that exponentially dwarfed the salary I'd make as a PA.

 

However, being married with kids in my 30s, I needed to sustain a living with very little downtime versus had I been younger or even without any wife or kids, then med school would have been the obvious choice. But I wanted to start my life in my 30's instead of when I was in my late 40's. IMO, if you're young without any ties or obligations, you should ask yourself "why am I it going to med school?" Because honestly, that's the question I always ask to myself when I see people applying for PA school that have no kids and are younger than 26...

 

I don't think you read all of my post. It's ok though, its easy to miss things. I was saying these young kids whose only reason to go PA is "because its shorter, less debt and I'll make money faster" are shortsighted, for the above mentioned reasons. I can see why, in your case, you took the path you chose. I'm 33, just finishing my 1st year of med school. I did extensive calculations as well, even if I went into the lowest paying field (family med), I would still come out on top significantly, opposed to staying a PA. But again, money is not a reason why I'm doing it. Also, I don't have a family, so its MUCH easier. Don't know if I would have gone back if I had a family. 

[Reality Check 2]

OH MY GOSH - this is such a dead horse and we are flogging it endlessly.

 

Hard is hard for different reasons for different people.

 

Either go to medical school or go to PA school - follow YOUR dream and follow your heart.

 

Don't belittle someone who chooses a different path for different reasons.

 

This thread is irritating to me professionally and personally as someone who has been a PA for a very long time.

 

I don't need to justify my career choices anymore than the next person.

 

In the immortal words of Frozen - LET IT GO.

[EMEDPA]

one more wrinkle to consider....moonlighting....I know a lot of FP and EM residents who end up with salary > PA during pgy2 and pgy3 because they pull moonlighting shifts at 100+/hr as docs...I know several em residents who made >150k/yr during residency (residency salary + moonlighting).