PA vs MD, specific circumstances, money not an issue, etc

[ariiiibar1021]

Hi, I had some questions regarding pa school vs med school that I was hoping to get some insight on from those who have more experience than I do, so I make the right decision and don't regret it in the future.

Prereq wise for PA school I still need biochem, microbio, genetics, and Ochem lab (depending on the school), for med school I just need biochem. I also need to take the gre/mcat. I'm 23 and just graduated undergrad in May 2017, am currently taking ochem at a local school. I do not have required hours for health care experience for PA school. Either way, I would apply summer 2019.

I would like to do PM&R if I'm an attending, which is not as "competitive" of a specialty and has a more regular hours residency (or so I hear).

My main concern is stress and burnout. I have been feeling this the last 2 years of undergrad and find it difficult to study occasionally, pending a school break. After a break, I am good again for some time, then burn out again but push through until the next break. My education will thankfully be funded by my parents (as long as I graduate), so debt concerns are not an issue. 

PA school is year-round (no summer). Med school has summer after first year, and 4th year is supposedly easier and not stressful. The residency I desire is also not difficult hour-wise (If I match into it). So, the difference is 2nd year and intern resident year in terms of difficult years between PA & MD school. I will have more options and a much higher salary as an MD. I also know I do like to be in charge decision wise. However, PA school will get me working sooner with less chance of burnout (or perhaps this isn't true as class attendance is required and there's no summer break, whereas med schools have students watching lectures on their own at double speed, and there is a summer). I value family and free time, but I think this is more dependent on setting than job title, although correct me if I am wrong. I do not want my job to be my life, but I know I enjoy this field and will enjoy my job while working.

What are your thoughts on my particular set of circumstances?

 

 

[LadyNichiavelli]

I feel like based on what you're searching for, you should aim for med school and really shoot for that residency. No matter how you cut it, school is transient and will end eventually. Your career is for life (unless you venture toward something else).

But you also need to find ways to minimize your burn out and make school a more enjoyable (although challenging) venture.

[MT2PA]

PA school burnout is REAL.  Your description of what you want in your career scream MED SCHOOL.  In the end, that's what will matter.

[bocc54]

I would strongly consider going to med school if you feel like you want to be in charge all the time. Burnout in PA school is very common. Not to say it isn't in med school, but it would be nice to have that time off that most PA students do not have. PM&R will also not be nearly as stressful as some of the other residencies out there. PM&R = Plenty of Money & Relaxation

[Ket131]

If you have been having feelings of burnout in undergrad, be ready to have it in either PA or Medical school, they are harder, for good reason.  At the same time you are doing something you actually want to do and that mediates burnout.

Want more control?  I guess that depends, MD will give you that with your work, but be ready to dance with the administrators more often.  Even I, as a lowly PCT, have to deal with people that don't touch patients, telling me how to work and the proper way to take care of patients, gets frustrating.  

As for MD salary, I don't know if this has changed as I haven't asked any one who recently graduated, but both my folks were Anesthesiologists and made under 30k a year as residents and did not "make the big bucks" until they were done with residency or at least further along into the residency.  I was just talking about this with my father the other day.

[Hzq]

It's ultimately up to you, but prepare to be stressed either route you take. Just keep in mind that there are pros and cons to each career. In response to being in charge, don't forget that many practicing PAs get a lot of autonomy depending on where they work, speciality, location, etc. I shadowed a PA once who ran the entire express clinic by himself while his MD partner was at a different hospital in a different city. Also keep in mind that MDs deal a lot with insurance companies and administrators and it makes them feel like business people more than caregivers (at least this is what the MDs/DOs I've come across have all told me). You just have to ask around and shadow and see what feels right for you. Either decision you make, if it's made with passion, will be a good one. 

[2wheels]

    Stress is the root of burnout. No matter what path you choose, there will likely be risk of burnout in the future. If not in school, then in the career to follow. It's an occupational hazard when you work as a care giver. It's good that you can recognize it now so you can learn how to deal with it because you will encounter it in the future no matter what. Don't trick yourself into thinking there is any time off in either field of study. As a PA student you are preparing to pass the boards for 24-30 months of training and it is always something you are actively preparing for, whether you're in class or on break. Med students, though they may not have the same classroom structure, have to constantly and actively prepare for med school exams, step exams, and all the stress and worry of scoring high enough to match where they want to match and do what they want to do, not to mention the stress of 80+ hours a week (usually much more) once they begin residency. It is a constant weight. 

Both paths are strenuous and will cause constant stress in your life, which will burn you out. The best thing to do is figure out a healthy way to sort through and relieve stress and enhance focus and then make sure that the path you choose is worth what you're giving up on the path you don't. 

[ariiiibar1021]

Thank you all very much for your insightful replies! Lots to think about.

[lkth487]

Where I do my residency, we have both PA students and medical students.  They both work very hard.  I haven't been to PA school but med school you're constantly worrying about exams.  First two years for the basic sciences and to score as well as you can on Step I, and then third year, you have to work hard as hell to impress everyone in every specialty PLUS study for shelf exams at the end of every rotation AND start preparing for Step 2.  Fourth year is "easier" theoretically but its probably more stressful - first you have to do Sub-Is in your specialty and impress everyone so you can get good letters and then you have the stress of the application season and the match.  

Intern year is very difficult - working 80 hours a week, constantly feeling like you don't know anything and getting worked to the bone.  I LOVED my intern year because it was the specialty that I liked.  But if you're interested in PM&R, you'd have to get through a medicine intern year, which is hard.  I hear PM&R residency is relatively chill, so there's that.

For what its worth, I'd choose this path again without a second's hesitation.  I had another career prior to this and even residency is more fun and way better.  I go home knowing I've helped people and I feel pretty satisfied.  I know friends who went to PA school after doing post-bac with me and they seem very happy as well.

Someone mentioned this before, but for residency salaries, most interns (known as PGY-1) make between 50k-65k and it goes up 2-3k per year of residency and fellowship.  There are opportunities to moonlight in some residencies to make extra $$.  There is usually a big jump when you're an attending, in terms of salary.