PA for a young male applicant?

[pa56]

Hi PA forum,

 

I am the father of a 23 y/o son, who's interested in going to PA school. I've been browsing these forums and it seems that many of the more experienced/older PAs always encourage younger applicants to go to medical school instead. Although I support his decision, I was wondering why someone would become a PA as their first career at a young age instead of going to medical school? 

 

A bit about his situation:

BS in Molecular Biology with a 3.90 GPA 

~3000 healthcare hours, with the majority of being a scribe and some as a HCT

He actually took the MCAT 3x and has a competitive score for DO schools, but I'm not sure about MD. He did apply to MD schools last year but did not get interviews. 

Research assistant, Leadership roles, short term jobs, etc. 

 

Originally becoming a physician was his goal, but he says that after working with many dissatisfied physicians in the ER, he wanted to go to PA school. He also said that the PAs that he spoke with were very happy with their careers. I apologize if I'm hitting on a touchy subject, but he said the only reason for going to med school for him would be the higher salary, since he understands that experienced PAs may end up doing many of the same things as physicians. Ultimately, he says he does not want to put in the time commitment of medical school + residency, competing for board exams for residencies, etc. He does not care about the prestige of being a physician but just enjoys being able to treat patients. 

 

I'm not asking for convincing arguments about how he should go to medical school but rather would just like to gather an understanding of why someone who's at a younger age (and male) would choose going to PA school instead.

 

Thank you for taking the time to read this post.  

 

 

Edit: Also, he is currently accepted to a PA program but has a DO interview in January. He says he does not wish to attend. I do ultimately support his decision to go to PA school but am wondering if he will regret it later down the line (say when he's 40) as many of the older PAs on this forum express. Again, no disrespect to the older PAs as I would love to hear their opinions as well. 

[BruceBanner]

I dont think being male has anything to do with it. There is a preponderance of female PAs, but women chose this career for (perceived) family reasons.

 

The cost of medical school is higher but there is more money earned over the span a career, even accounting for this debt. The trade-off is the time commitment to training and in most cases longer work hours; although PAs can certainly work long hours as well.

 

Many people choose to be PAs for reasons your son listed. I did. Some of us just dont care about the title and dont want the additional 6+ year training commitment.

 

The boomer generation seems to think males in particular should be doctors if they are going to be in medicine at all. It's just a generational thing. The only people who ask me the annoying question "so when are you going to be a full doctor?" are the over 55-ers. 

[Boatswain2PA]

Tell him to go to Med school.

[LKPAC]

He should not assume that PA school is easier than MD.  Basically, you learn (the important) 90% of what a doc learns in 50% of the time.  So if that is a factor, he should know that in advance.  Make sure he thinks this through carefully.  Become a PA because that is what he wants, not because he is settling, just because he didn't get accepted to MD program the first time.

[WeBuyAndSellJunk]

As someone who is a younger individual I think that the biggest benefit that I have found in being a PA versus going to medical school is that I am not as shackled to this as a 40+ year career. I think the millennial generation, in general, tends to not see themselves as "lifers" in any job. I have completed PA school and will have paid off my students loans in 6 years total. That is drastically different than 7+ years for medical school education and who knows how many more to pay off medical school debt. I like the prospect of changing careers or even considering going back to medical school, which I suspect would be much easier than going in with a blank slate. I especially like that idea now that I see how many people are dissatisfied with long, arduous careers in an ever-changing medical field. It is not for everyone and that is difficult to tell when you are in your early 20's. 

[EMEDPA]

my take: I was premed in college and had a lot of the same arguments your son lists. I was afraid of the time commitment, etc of MD and thought I would be ok with PA scope of practice. problem is, 5 years out I knew I had made a terrible mistake. I need to run the show and be able to work to the full extent of my training and experience without someone else constantly second guessing me., I have been a PA for 20 years now and just in the past few years landed jobs where I truly am interchangeable with a physician. I work solo/rural emergency dept jobs hours away from home in order to not hate what I do every day. I tried to go back to school a few times, took extra prereqs and got good grades, etc, but life intervened. wife lost job, etc so to make the most of it I am trying to be the best em pa I can be. I went back and got a doctorate in global health while working full time in order to expand my options for overseas work. the biggest regret of my life to this point was the decision to switch premed to PA.  my dad was a doc and was unable to do the work/life balance thing. seeing docs I work with now who work a lot less than I do, I know I could have succeeded where he failed. If I had a time machine, I would go back and tell my 19 year old self to just suck it up.

[IDCtoPA]

I think you have gotten lots of good advice here.

 

EMDPA hit on the key point. Some people NEED to be the one "running the show" those folks are likely going to struggle with dissatisfaction over the long term as a PA. I suspect that many of them struggle with dissatisfaction as MD/DO given the world of corporate medicine and insurance pre-authorizations, etc..  

 

There are also people who do not feel that need to run the show. You know your son. Does he NEED to run the show?

 

It sounds like he knows what he wants. I would encourage him to attend the interview and make a decision after. And, I would support what ever decision he makes. 

[EMEDPA]

there is more to it than "running the show". respect is a big thing too. you need to have a thick skin to be a PA and deal with docs who "don't talk to PAs" on the phone or nursing supervisors who constantly put down PAs, etc. I was lucky that my first job was really good. I trained with physicians at a place with an fp residency. my sp treated me like any other intern, which was awesome. unfortunately, that job had a fairly limited scope of practice so when I moved up within the same organization I ended up working at a place where the PAs were administratively managed by a nursing supervisor. not ideal. I've had several bad and good jobs since then and just settled into an arrangement in october where I work at 3 places that respect me and am glad to see my face when I walk in the door. I have no limits within the specialty with regards to my scope of practice. it took me 20 years and involves a lot of driving...one place is far enough away that I bought a studio condo for my shifts there.

[IDCtoPA]

there is more to it than "running the show". respect is a big thing too. you need to have a thick skin to be a PA and deal with docs who "don't talk to PAs" on the phone or nursing supervisors who constantly put down PAs, etc.

 

Agreed. Good point. 

[GetMeOuttaThisMess]

One question to consider is could he be happy doing the same thing for 35-40 years or would he need variety? If the latter, then clearly go to PA school. I'm soon to be 34 years in and in no way could've stayed in one specialty area (ortho spine, cardiology, EM, FM, employee health, internal medicine, and now back to employee health to close out the career, I hope). The ability to fully control your work schedule as a physician is no longer the case in most practices since they're corporate employees also.

[EMEDPA]

One question to consider is could he be happy doing the same thing for 35-40 years or would he need variety? If the latter, then clearly go to PA school. I'm soon to be 34 years in and in no way could've stayed in one specialty area (ortho spine, cardiology, EM, FM, employee health, internal medicine, and now back to employee health to close out the career, I hope). The ability to fully control your work schedule as a physician is no longer the case in most practices since they're corporate employees also.

if you are an fp doc you can do almost anything; ob, derm, procedures, scopes, hospitalist, em, etc. that is the way to go.

[MT2PA]

Sounds like your son has made up his mind and you're looking for reasons to change it.  

 

He's given you his reasons for PA instead of MD/DO.  Being a male has NOTHING to do with anything in this discussion.

 

As much as PA used to be a second/third/fourth career, it is very much becoming a first/only career option.  That's not necessarily the case for the 'older' crowd on here (it wasn't really viewed as a first career 10/20/30 yrs ago).  PA is not a stepping stone to MD.  It is not a lesser career than being an MD.  It is it's own path.  

 

Do some regret not going the MD route instead of PA?  Sure.  Are there MDs that wish they had done PA?  I bet so.  Are there some in each camp that are absolutely happy with their decision?  Yes.

 

He's 23.  He's made up his mind.  The likelihood that any 23 y/o will regret his career choices at 40 is something that could happen in any field.  He could go MD and regret that at age 40, too.  He could do PA or MD and decide in 10 years he hates medicine.  It's his life to live and it sounds like he's thought through his decision.  Respect it.

[GetMeOuttaThisMess]

Sounds like your son has made up his mind and you're looking for reasons to change it.

 

He's given you his reasons for PA instead of MD/DO. Being a male has NOTHING to do with anything in this discussion.

 

As much as PA used to be a second/third/fourth career, it is very much becoming a first/only career option. That's not necessarily the case for the 'older' crowd on here (it wasn't really viewed as a first career 10/20/30 yrs ago). PA is not a stepping stone to MD. It is not a lesser career than being an MD. It is it's own path.

 

Do some regret not going the MD route instead of PA? Sure. Are there MDs that wish they had done PA? I bet so. Are there some in each camp that are absolutely happy with their decision? Yes.

 

He's 23. He's made up his mind. The likelihood that any 23 y/o will regret his career choices at 40 is something that could happen in any field. He could go MD and regret that at age 40, too. He could do PA or MD and decide in 10 years he hates medicine. It's his life to live and it sounds like he's thought through his decision. Respect it.

.

 

He's nearly at the same point I was in '80 when I applied and started in '81. It was a primary career choice for myself because at that time only the brainiacs were getting into medical school. There were only three MD programs in the great state of Texas at that time, with the DO program in FW. 6 of 7 males in the class before went to med school. In my class of 9 only 2 went back.

[mgriffiths]

I am 27, male, married since 22, and finished PA school as of today!!!!!!!!!!! Technically this is my 2nd career as I taught high school science for a couple of years.  But, when I started the process of leaving teaching, taking prerequisites, and applying to PA school I was 24 - so maybe my perspective is valid, maybe not.  Started PA school at 25.

 

Being married played a huge part in deciding between med school and PA school, but it was not the defining factor.  I have a father who is a FM doc and he did an excellent job of balancing home and work life.  I truly never understood how much and how hard he worked until I was out of college and would travel "home" for vacations with the wife.

 

I chose PA school because I wanted to provide for patients and PA school was the fastest way to accomplish that goal.  I wanted an excellent salary with good autonomy, but I am not concerned with "running the show."  Maybe it is my generation, but I want to "work to live" not the other way around...in other words I don't want my job to control my life.  My father is one of multiple owners in his private practice and he does not run the show.  He still gets slammed with patients at times, cannot take vacation whenever he wants, etc.  Being a doctor today is not as glorious as it once was, especially with the red tape involved.  In fact, medicine today is fighting against doctors in many ways, and doctors are becoming more and more frustrated.

 

As my father put it: "If I want to make money, become a stock broker.  If I want to care for patients, become a PA."

 

DO NOT CHOOSE MEDICAL SCHOOL FOR THE MONEY, you will likely be sorely disappointed and will be one of the 50% of MDs who regret their decision entirely.

 

If you have any specific questions, feel free to PM me.  I would be happy to answer pretty much anything.

[SoCal_PA]

I'm a male PA who entered PA school at age 23 as well. I work in emergency medicine now and enjoy it. Shoot me a message if you'd like

[MT2PA]

.

 

He's nearly at the same point I was in '80 when I applied and started in '81. It was a primary career choice for myself because at that time only the brainiacs were getting into medical school. There were only three MD programs in the great state of Texas at that time, with the DO program in FW. 6 of 7 males in the class before went to med school. In my class of 9 only 2 went back.

 

I"m willing to bet it wasn't common though.  At least, not like it is today to go right from undergrad to PA school.  Especially when these days most 22/23 y/o don't find themselves restricted to locations and have nearly the entire country as an option.  And the brainiacs are doing either these days!

[GetMeOuttaThisMess]

Majority of my class were <25 y/o. Can't speak for today. I hadn't finished my BS in Bus. Mgmt. at UT Austin when accepted.

[MT2PA]

Majority of my class were <25 y/o. Can't speak for today. I hadn't finished my BS in Bus. Mgmt. at UT Austin when accepted.

 

You started a trend then.  My class isn't even mostly under 25 now.

[pa56]

Wow, thank you all for your opinions! I could not have guessed that so many of you would have responded. To add, I don't think he's at all worried at all about working under/with a physician, as long as he's perceived as a competent provider. I suspect this would come with experience and as relationships are built with physicians. 

 

As someone who is a younger individual I think that the biggest benefit that I have found in being a PA versus going to medical school is that I am not as shackled to this as a 40+ year career. I think the millennial generation, in general, tends to not see themselves as "lifers" in any job. I have completed PA school and will have paid off my students loans in 6 years total. That is drastically different than 7+ years for medical school education and who knows how many more to pay off medical school debt. I like the prospect of changing careers or even considering going back to medical school, which I suspect would be much easier than going in with a blank slate. I especially like that idea now that I see how many people are dissatisfied with long, arduous careers in an ever-changing medical field. It is not for everyone and that is difficult to tell when you are in your early 20's. 

What do you mean "shackled to this as a 40+ year career"? I do think that he wishes to be a PA in order to enjoy his youth a bit more, but I feel that going to medical school would only be 2 years difference. In regards to residency, I do understand that hours can be very long (~80-100hrs/week), but you are still being paid a liveable salary at that time while a full time PA would also be working with ~3 weeks/year PTO similar to residents. Or am I wrong? Obviously, I'm probably of significantly older age than you, so my view may be biased since in my generation, we were expected to work hard for that better life down the road (I am a 1st generation immigrant). In regards to work/life balance in general for physicians vs. PAs, I have seen on this forum that hours are pretty equivalent in most specialties except for surgery or am I wrong again? 

 

my take: I was premed in college and had a lot of the same arguments your son lists. I was afraid of the time commitment, etc of MD and thought I would be ok with PA scope of practice. problem is, 5 years out I knew I had made a terrible mistake. I need to run the show and be able to work to the full extent of my training and experience without someone else constantly second guessing me., I have been a PA for 20 years now and just in the past few years landed jobs where I truly am interchangeable with a physician. I work solo/rural emergency dept jobs hours away from home in order to not hate what I do every day. I tried to go back to school a few times, took extra prereqs and got good grades, etc, but life intervened. wife lost job, etc so to make the most of it I am trying to be the best em pa I can be. I went back and got a doctorate in global health while working full time in order to expand my options for overseas work. the biggest regret of my life to this point was the decision to switch premed to PA.  my dad was a doc and was unable to do the work/life balance thing. seeing docs I work with now who work a lot less than I do, I know I could have succeeded where he failed. If I had a time machine, I would go back and tell my 19 year old self to just suck it up.

Thank you so much for your input EMEDPA. I am sorry to hear that the PA profession didn't turn out as you would have hoped, but I do hope you find better opportunities overseas. I have seen you post quite frequently in similar threads in regards to the lack of respect that is sometimes associated with being a PA. Other than this and having the need to "run the show", would you say that it took nearly 20 years of experience to earn similar respect to physicians or was it just the poor work environments that you started off in? I have heard that the PA profession is taking great strides within recent years to being recognized by both patients and the healthcare team as being excellent healthcare providers but was curious on your personal opinion. 

 

 

if you are an fp doc you can do almost anything; ob, derm, procedures, scopes, hospitalist, em, etc. that is the way to go.

Are there restrictions to practicing as a hospitalist or in emergency medicine if you go med school and undergo a family medicine residency? Such as additional training, etc. 

 

 

Sounds like your son has made up his mind and you're looking for reasons to change it.  

 

He's given you his reasons for PA instead of MD/DO.  Being a male has NOTHING to do with anything in this discussion.

 

As much as PA used to be a second/third/fourth career, it is very much becoming a first/only career option.  That's not necessarily the case for the 'older' crowd on here (it wasn't really viewed as a first career 10/20/30 yrs ago).  PA is not a stepping stone to MD.  It is not a lesser career than being an MD.  It is it's own path.  

 

Do some regret not going the MD route instead of PA?  Sure.  Are there MDs that wish they had done PA?  I bet so.  Are there some in each camp that are absolutely happy with their decision?  Yes.

 

He's 23.  He's made up his mind.  The likelihood that any 23 y/o will regret his career choices at 40 is something that could happen in any field.  He could go MD and regret that at age 40, too.  He could do PA or MD and decide in 10 years he hates medicine.  It's his life to live and it sounds like he's thought through his decision.  Respect it.

I'm not trying to change his opinion but like I said, I wanted to really understand why a younger applicant who has a DO interview would want to just take his PA acceptance and just run with it, especially when he had his mind set for becoming a physician for the entirety of his 4 years of college. He only recently within the past <1 year decided that he wanted to go to PA school instead. Admittedly, I did encourage him to apply to medical school again this year but I am by no means pressuring him to do what he doesn't want to do. I just hope he's fully informed about his decision (he doesn't know I have made this post, but I may decide to show him and encourage him to at least attend the DO interview before making his final decision, such as IDCtoPA said above). 

[Boatswain2PA]

Sounds like the sum of the advice is this:

Young people say go PA.

The Gray-hairs and No-hairs (except for EMEDPA, who somehow has retained his RED hair) - all say he should go to med school.

Makes me wonder what all of those young people will say when they have gray hair or no hair.

hmmm.....

[south]

It really sounds like he has done a lot of in-depth research and soul-searching and has made up his mind.  His reasoning is sound and I see no problems in his logic.  I admit to some bias, because I agree with him.

 

One thing - you don't mention money hardly at all, but that end of it is terrible to unworkable.  

 

I just deleted a long detailed discussion, but bottom line, once you start your first MD job at $165-170k per year 10 years from now you could easliy be $500k in the hole. (residents make around $44k/year for those 4 years of misery) I have talked to new docs who owe close to $800k.  Compounded daily.

 

But hey, you got to live in relative poverty somewhere not of your choosing (twice, 4 years each) (possibly very crappy) and your life has been pretty miserable to that point.  Now you will scratch and claw to get paid a living wage (relative to your expenses) in the face of stuff like loans, declining reimbursement, and MedMal.  

 

Medical school is for young kids that are able, willing and eager to withstand all these hardships and setbacks early in life, giving up everything else because they are just so incredibly driven and/or competitive, and yes, the top echelon will make decent money after many years.  I salute them and have tremendous respect for that, but not my thing. 

 

PA school is for people who like patients and medicine, and want to get the necessary education via the firehose method in a third of the time, and move on and generally have a pretty comfortable life of their choosing (money, hours, work type), maybe room for something else like a family or hobbies.

 

When my time came, in my early 40s, I could have likely gotten into a pretty decent medical school, but I found myself saying a lot of the exact things he is.  For me, and only for me, medical school seemed like a tremendous waste of time and money, for ever-diminishing returns, and I was not even remotely interested.  For me, it was PA or something in another field entirely.  

 

If you are still unconvinced, look no further than your local physician, ones he's worked with or, hell, even internet (disclaimers apply there).  6 years of this process and I have YET to have someone tell me they would do it again in these conditions.  

 

I've got kids myself, and I have physicians in the extended family so I get it.  But it seems he's really got this one handled.  At least he doesn't want to become a DJ or professional video gamer, right?

[Boatswain2PA]

.... you don't mention money hardly at all, but that end of it is terrible to unworkable.  

 

I just deleted a long detailed discussion, but bottom line, once you start your first MD job at $165-170k per year 10 years from now you could easliy be $500k in the hole. (residents make around $44k/year for those 4 years of misery) I have talked to new docs who owe close to $800k.  Compounded daily.

 

But hey, you got to live in relative poverty somewhere not of your choosing (twice, 4 years each) (possibly very crappy) and your life has been pretty miserable to that point.  Now you will scratch and claw to get paid a living wage (relative to your expenses) in the face of stuff like loans, declining reimbursement, and MedMal.  

 

Medical school is for young kids that are able, willing and eager to withstand all these hardships and setbacks early in life, giving up everything else because they are just so incredibly driven and/or competitive, and yes, the top echelon will make decent money after many years.  I salute them and have tremendous respect for that, but not my thing. 

 

PA school is for people who like patients and medicine, and want to get the necessary education via the firehose method in a third of the time, and move on and generally have a pretty comfortable life of their choosing (money, hours, work type), maybe room for something else like a family or hobbies.

 

When my time came, in my early 40s, I could have likely gotten into a pretty decent medical school, but I found myself saying a lot of the exact things he is.  For me, and only for me, medical school seemed like a tremendous waste of time and money, for ever-diminishing returns, and I was not even remotely interested.  For me, it was PA or something in another field entirely.  

 

If you are still unconvinced, look no further than your local physician, ones he's worked with or, hell, even internet (disclaimers apply there).  6 years of this process and I have YET to have someone tell me they would do it again in these conditions.  

"that end of it is terrible to unworkable".  I know MANY Docs, FP to specialists, who have Student Loans paid off and are multi-millionaires.  I know several female FP docs who have 3-5 kids and work about 20 hours a week and make MUCH more than the FP PA.  

 

Average pay of a resident is $52K a year, not $44K.  Less during intern year, more during senior years.  Furthermore, this does NOT include moonlighting which is often done during the second year (and beyond).  

 

I've NEVER met a doc who had anywhere near $800K in student loans.  If you have, then that Doc lived beyond their means during undergrad, med school, and residency.  This is inexcusable.

 

Yes, medical school is for PEOPLE who are willing to endure hardships and setbacks.  You did read that the OP is a FIRST GENERATION IMMIGRANT, right?  This guy left his familial COUNTRY, and sacrificed more than you or I could probably IMAGINE, just so his wife/kids could have a better life.  Then you come along and tell him Med School is for people who want to work hard.

 

Have you ever SEEN what people will come through to come to America to live the dream we have?  I have, and I have picked up way too many of the bodies of those who didn't make it.

 

PA school is for people who like patients and medicine?  Yeah.....so is med school.  I know several docs who have "room for something else like a family or hobbies."

 

You apparently chose PA in the early 40's.  So did I.  Yes, at 40, the financial returns of medical school is probably overshadowed by the effort and debt, but not for those in their 20s.  

 

And regarding asking your local physician....the grass is always greener.  Lots of Docs wish they were on the other side of the fence (PA, lawyer, stock  broker, etc).  But if you ask those guys (the PA, lawyer, stock broker, etc.), many of them would probably say they wish they were physicians.

 

 

[WeBuyAndSellJunk]

My thought is that it becomes very difficult to change careers when you are a physician. You have invested 4+4+3+ years of your life to getting there. Once you are there, you have, typically, 5-10 years of debt to pay off. It is really hard to walk away from that if you find you do not like it. Most of the time you can't as you are stuck by your school debt, McMansion debt, car debt, lifestyle creep, etc... You can certainly help yourself not be as stuck with regard to your specialty, but most 20 year olds have little to no concept of what a job in medicine is like until 2-3rd year of residency. It was a risk I was not willing to take. I happened to find that I enjoy family practice, but I can already feel that I will want to change specialties. That may not be as much of a reality in the future, but it is an option for a PA now.

 

I am nearly debt free at 30. I have a great job, but I also feel like I could step away from it and study something else if I wanted to. Everyone is different in what they want, medicine is changing/changed, and I am simply giving you my bet on my own future desires. That may or may not resonate with your son.

 

Also, sorry for the rambling. This was a 6:30 AM post prior to coffee. Cheers!

[BruceBanner]

You do need to have a durable ego if you're going to be a PA.

 

Depends on the setting of course, but as a PA you can expect:

 

-to always have your decision-making scrutinized by some physicians

-to have your charting scrutinized to much higher degree than physicians

-to deal with the stigma that you order too many tests, call too many specialists, or cant handle complex problems

 

There is a higher degree of default respect, both by the public and all levels of healthcare workers for physicians. In addition, there are numerous business avenues available simply by right of title. "MD" confers instant credibility for consulting, authorship, specialized medical work like being a ringside physician, expedition physician, etc. There is just more opportunity.

 

I have moments where I wish I was a doc, but not often. If I was 23 and had little to no college debt, I'd probably have gone that route. But I was 28 when I started and already in debt from undergrad, so it just didnt make sense logistically...being a "work to live" rather than "live to work" kind of guy.

[myironlung]

I chose to go PA around age 23 after I got my BS. Realized I couldn't do much with exercise science degree besides open a gym. I just really enjoyed those classes in school and stayed with it, it was better than sitting through boring business classes even though there would be more jobs after college for me.

 

MD/DO would have taken too long, too much debt. I wanted to have a well paying job sooner. I liked health science courses, medicine. That's basically it. I have no regrets. The only thing that's annoying is people's misconceptions about PA's (what they are, their scope etc..) Having to explain it over and over is annoying, but it's also annoying explaining to people over and over I won't give benzos, opiates or a "z-pack" which I'm sure MDs hate as well. If your son wants PA, go for it.