PA vs AA

[cemetra]

I’ve been interested in becoming a PA for about 6 months now - still currently on my undergrad classes. I’ve recently found out about AA’s though, and I’m thinking it sounds really nice too. A few things to consider:

I enjoy surgery and helping people, but I’m an INTP. Basically, I’d prefer my patients under general anesthesia (my attempt at a joke).

Yes, PA’s can “switch” a lot. But I’m not interested in anything other than surgery or possibly internal medicine, although I do have an indecisive personality. I like the idea of speaking with patients before and after surgery and being some part of the surgery itself, without having the major responsibility, but I’m not trying to see 30 patients a day and write prescriptions for people with colds. I’m also a fan of having doctors over me.

I want a normal lifestyle. I want to work 3 12 hour shifts and enjoy 4 days off, with taking some calls from time to time. I’ve worked 60 hours a week for the last 4 years and I want some extra time. I want to enjoy my younger years. I want to travel. I want to start a family. I want to continue putting time into my one-for-one company and help others. I want to read books. I want to write books. I want to watch my kids grow up and relax throughout the week. Etc.

This being said, I really, really love helping people. I’m okay with working ridiculous hours when I’m needed. I’m okay with being there for the team and doing whatever it takes to get the job done. I will be there. I just want to still be able to step away sometimes and enjoy myself. This is the main reason I want to do either an AA or PA.

I’m under the impression AA’s make more money and have a more reliable schedule as well.

*ALSO* I know AA’s aren’t accepted as many states, this is a common mention when I look through other forums. But the states are growing. I think I read it should be 25 states close to 2020? Either way. I’m from Georgia. All my surrounding states and where I’d want to live anyways are covered to be an AA.

I’m currently in school to be a surgical tech, so I’ll have some good clinical experience under my belt as well.

Sorry to ramble, but what do you guys think? How do you feel about PA vs AA?

All opinions welcome. Mean or nice. Honesty is appreciated.

Thanks for your time!

[beachbulldog]

I’ve been interested in becoming a PA for about 6 months now - still currently on my undergrad classes. I’ve recently found out about AA’s though, and I’m thinking it sounds really nice too. A few things to consider:
I enjoy surgery and helping people, but I’m an INTP. Basically, I’d prefer my patients under general anesthesia (my attempt at a joke).
Yes, PA’s can “switch” a lot. But I’m not interested in anything other than surgery or possibly internal medicine, although I do have an indecisive personality. I like the idea of speaking with patients before and after surgery and being some part of the surgery itself, without having the major responsibility, but I’m not trying to see 30 patients a day and write prescriptions for people with colds. I’m also a fan of having doctors over me.
I want a normal lifestyle. I want to work 3 12 hour shifts and enjoy 4 days off, with taking some calls from time to time. I’ve worked 60 hours a week for the last 4 years and I want some extra time. I want to enjoy my younger years. I want to travel. I want to start a family. I want to continue putting time into my one-for-one company and help others. I want to read books. I want to write books. I want to watch my kids grow up and relax throughout the week. Etc.
This being said, I really, really love helping people. I’m okay with working ridiculous hours when I’m needed. I’m okay with being there for the team and doing whatever it takes to get the job done. I will be there. I just want to still be able to step away sometimes and enjoy myself. This is the main reason I want to do either an AA or PA.
I’m under the impression AA’s make more money and have a more reliable schedule as well.
*ALSO* I know AA’s aren’t accepted as many states, this is a common mention when I look through other forums. But the states are growing. I think I read it should be 25 states close to 2020? Either way. I’m from Georgia. All my surrounding states and where I’d want to live anyways are covered to be an AA.
I’m currently in school to be a surgical tech, so I’ll have some good clinical experience under my belt as well.
Sorry to ramble, but what do you guys think? How do you feel about PA vs AA?
All opinions welcome. Mean or nice. Honesty is appreciated.
Thanks for your time!

Please define AA. There are many acronyms in healthcare and that’s not one I’m familiar with. At least not something I’ve heard about here in VIrginia.


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[DiggySRNA]

If you're highly considering AA I would seriously think about being a CRNA (Certified Registered Nurse-Anesthetist). 

My main reason is that CRNAs can practice in all 50 states whereas AAs can only practice in 13 the last time I checked. That number may have increased. 

Becoming a CRNA may take longer but the potential to move wherever you want and not having to worry about does your future state allow practice rights.

In the surgery realm PAs are first-assists and focus on pre-op/post-op rounding and patient care - I do not think they are utilized in providing/controlling anesthesia per se. CRNAs put patients under, maintain life, and bring them back to reality. Not sure if they round and provide post-op care. So it depends on what you want  to focus your career on.

[EMEDPA]

Anesthesiologist Assistant.

good career. good salary. same scope as crna, but can't work without a collaborating doc. limitation in geography as you mentioned. one of the programs has a PA to AA bridge program. admission more rigorous than PA school. all require mcats, physics, biochem, etc. 

http://www.anesthetist.org/faqs

[EMEDPA]

3 minutes ago, Diggy said:

If you're highly considering AA I would seriously think about being a CRNA (Certified Registered Nurse-Anesthetist). 

My main reason is that CRNAs can practice in all 50 states whereas AAs can only practice in 13 the last time I checked. That number may have increased. 

you have to become an RN first and have years of icu experience to get into crna. AA can be done straight from undergrad. AAs can also work in all federal facilities. 

[DiggySRNA]

Just now, EMEDPA said:

you have to become an RN first and have years of icu experience to get into crna. AA can be done straight from undergrad. 

Yup, I forgot to add that in my original post. Whoops

[EMEDPA]

CRNAs can practice independently in a growing # of states, just like NPs. I work with some great crnas at rural facilities. 

[cemetra]

16 minutes ago, EMEDPA said:

you have to become an RN first and have years of icu experience to get into crna. AA can be done straight from undergrad. AAs can also work in all federal facilities. 

This is the main reason why I’d consider it over CRNA. I don’t want to be a nurse first. I’m interested in helping patients, but more in a surgical term. Nurses are more nurse taught, I’m interested in medical/science ways, if that makes sense.

[cemetra]

@beachbulldog AA is Anesthesiologist Assistant. More or less same prerequisites for PA school, but I don’t think they need clinical experience first, they get that during the program. Although I’d be working as a surgical tech, so I’d have clinical experience regardless.

[EMEDPA]

15 minutes ago, cemetra said:

@beachbulldog AA is Anesthesiologist Assistant. More or less same prerequisites for PA school, but I don’t think they need clinical experience first, they get that during the program. Although I’d be working as a surgical tech, so I’d have clinical experience regardless.

AA prereqs are a bit more stringent with mcats, physics, biochem, precalc or higher math, etc

[Guest blee100]

I was shadowing a surgeon and he stated that about 18 states allow pas to specialize in Anesthesiology. Is this true?  I've tried to research but I keeping a yes answer and then a no answer on another site.

[EMEDPA]

1 minute ago, blee100 said:

I was shadowing a surgeon and he stated that about 18 states allow pas to specialize in Anesthesiology. Is this true?  I've tried to research but I keeping a yes answer and then a no answer on another site.

he is talking about AAs, another creature entirely...but hey, all us assistants are the same, right? 

[cemetra]

@EMEDPA could you elaborate on how their a different creature entirely? Like for example a surgical PA and an AA? I assumed the PA would work more hours, more hands on, more patient interaction. AA’s are more of getting the patient started out, then mostly monitoring everything goes smooth, then waking them up or taking them to the ICU and on to the next one.

I know all the PA programs I’ve looked at accepted a lot of similar prerequisites, and also some required GRE or Mcat. I’d prefer the GRE since I’d think it would be easier for me.

All in all, I’ve looked at PA for about 6 months obsessively. Found out about AA’s recently and started looking into it. Looks like more money and a more predictable schedule, but more “boring” and mundane tasks overall. It’s fine with me though. Observing a variety of surgeries while helping an anesthesiologist seems nice.

[cemetra]

@blee100 I couldn’t tell you, but it wouldn’t surprise me. I think PA’s can specialize in practically anything, it seems (don’t quote me). I think overall AA’s make more though, so it would be better to be an AA straight out. Or maybe a PA then AA. I’m not the best people person but I love helping people, that’s why I’m big into surgery. If I did PA, it would either be surgery or something more laid back like internal medicine. But my most important thing is time. I value my time heavily and want a life outside of work and to travel and etc. Wow, I got a little off topic. Sorry! :)

[EMEDPA]

AA are limited to anesthesia. PAs can do any field except operative anesthesia. 

AAs make really good money to start that overlaps with the top PA salaries. If I had to guess I would put typical AA salary at 150-250k with typical PA salary at 90-150k with some making 200+ after many years or in very specific fields like CT surgery or EM. 

[beachbulldog]

[mention=135337]beachbulldog[/mention] AA is Anesthesiologist Assistant. More or less same prerequisites for PA school, but I don’t think they need clinical experience first, they get that during the program. Although I’d be working as a surgical tech, so I’d have clinical experience regardless.

I’m sure I’m not the only person who may have had that question. I’ve never seen these two career options compared, but maybe someone else on here has. I’ll just say there are a couple Surgical Assistants (Masters level graduates) that went back to school to get a PA degree because they wanted more clinical medicine & more continuity of care with patients. Good luck!!


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[cemetra]

@EMEDPA yeah, I try not to let money be a big factor on my decision, but making ~ $150k starting is just amazing. Plus I’m not the best people person, although I feel like I’m decent one on one. I’m pretty good in teams and working under someone as well. One of the main reasons I wanted to attempt PA was to maybe come out of my shell a little more. I think AA is more suited towards my personality and offers a more relaxed lifestyle and time off, but everyone acts as if being an AA is doomsday waiting to happen and all CRNA’s will take over. That’s my biggest concern with it.

[EMEDPA]

12 minutes ago, cemetra said:

@EMEDPA yeah, I try not to let money be a big factor on my decision, but making ~ $150k starting is just amazing. Plus I’m not the best people person, although I feel like I’m decent one on one. I’m pretty good in teams and working under someone as well. One of the main reasons I wanted to attempt PA was to maybe come out of my shell a little more. I think AA is more suited towards my personality and offers a more relaxed lifestyle and time off, but everyone acts as if being an AA is doomsday waiting to happen and all CRNA’s will take over. That’s my biggest concern with it.

I think AAs have a bright future. many anesthesiology groups prefer them > crnas because they can't work solo and "steal their jobs". if money is an issue, you can probably make as much as an AA after 5 years as a PA in em, derm, ortho, CT surg, or neurosurg. 

[SrTaM]

I can't comment on the AA route, but I was similar to you in that I was POSITIVE I only wanted to do surgery. I went the surg tech route for my PCE (I start PA school this fall).

After working as a surg tech, I have very little interest in working in surgery as a PA. There would a few surgical specialties I MIGHT consider, but I think it's unlikely. I shadowed primary care PAs and knew very quickly it'd be a better fit for me. Just adding this to say that while an AA career may be appealing for wanting to work in the OR (or CRNA, as others have mentioned), I'm extremely happy I've chosen the PA route for lateral mobility. 

Obviously, you'll figure out pretty quickly as a surg tech how much you may/may not end up liking the OR. 

[rev ronin]

4 hours ago, EMEDPA said:

AA are limited to anesthesia. PAs can do any field except operative anesthesia.

Within the surgical field.

There's a list of things here in Washington PAs are not allowed to do, which, roughly translated, means "PAs are not ODs, DDSs, DCs, or DPMs"

https://app.leg.wa.gov/RCW/default.aspx?cite=18.71A&full=true#18.71A.060

I expect other states have similar but not identical lists.

[EMEDPA]

42 minutes ago, rev ronin said:

Within the surgical field.

There's a list of things here in Washington PAs are not allowed to do, which, roughly translated, means "PAs are not ODs, DDSs, DCs, or DPMs"

https://app.leg.wa.gov/RCW/default.aspx?cite=18.71A&full=true#18.71A.060

I expect other states have similar but not identical lists.

yes, while we certainly can't do full practice in those fields PAs can do subsets of their scope to include dental blocks, toe procedures like ingrown toenail, ankle/foot dislocation and fx reduction, slit lamp use to remove FBs, specific osteopathic manipulations if trained, etc

[beachbulldog]

[mention=73688]EMEDPA[/mention] could you elaborate on how their a different creature entirely? Like for example a surgical PA and an AA? I assumed the PA would work more hours, more hands on, more patient interaction. AA’s are more of getting the patient started out, then mostly monitoring everything goes smooth, then waking them up or taking them to the ICU and on to the next one.
I know all the PA programs I’ve looked at accepted a lot of similar prerequisites, and also some required GRE or Mcat. I’d prefer the GRE since I’d think it would be easier for me.
All in all, I’ve looked at PA for about 6 months obsessively. Found out about AA’s recently and started looking into it. Looks like more money and a more predictable schedule, but more “boring” and mundane tasks overall. It’s fine with me though. Observing a variety of surgeries while helping an anesthesiologist seems nice.

I would imagine a heavier chemistry prerequisite load for AA’s then? At least compared to what I had to take to get into PA school. I need to do research to comment more as AA’s aren’t something that are popular in VA yet (to my knowledge). I’d be interested to understand the difference between the education reqs & job responsibilities between a CRNA & AA though. The kind of $$ EMEDPA mentions for an AA role makes it sound like there’s a lot of risk & responsibility associated w/ the job. While over time some of the tasks may become mundane, the ramp up period is likely to be intense. Perhaps more intense than you anticipate. Talk to some AAs firsthand if you can.


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[scott079]

Hello Cemetra,

I thought I would share with you my story/ basic knowledge as I switched from pursuing PA school to AA school. I shadowed PA's in outpatient oncology clinic, EM, trauma, in-patient oncology, and about 4 different surgery specialties. I have spoken with PA's in about 3 other areas at length. Then I went on a medical mission and spent a ton of time with an anesthesia provider. I returned and shadowed a couple CRNA's and drove to Vermont to shadow an AA. 

I will echo that what I saw the AA do seemed virtually identical to what I saw the chief CRNA do at a huge hospital, both working in the ACT model. Both providers were extremely happy with the job. Both are what I would consider very hands on jobs with some downtime (like being a pilot). The AA was semi-retired at 55 and spending plenty of time with his kids. I could go on about what I saw in terms of the work, just let me know?

What I found very interesting was how the CRNA's responded to my interest in the AA job. They all said how much more autonomy they have compared to the AA's. Then I asked while sitting in the OR shadowing "isn't this an ACT model your working in right now? Didn't the anesthesiologist just come in for induction and will be back at emergence?" Their response was "yes but if the MDA is busy I can do those things without them, or they said they can work in a rural place solo and make a lot more money".  I brought that up because I spoke with CRNA's who when asked about solo work they noted how scary it can be to have no backup, others are up for that challenge and the solo money is sick (300k). It really depends on you. 

I choose this route because I really like the OR, the one to one patient ratio, the applied physiology, and I felt an AA has more autonomy in the OR than many surgery PA's, just my opinion. Also, I want to get Paid and AA's make good money and I see alot of offers with 6 or more weeks vaca and 1.5x hours over 40. Best of luck with your choice.

 

 

[cemetra]

@beachbulldog all the AA school prereqs I've seen honestly looked not as intense as the PA school requirements. PA schools have like 6-8 preqs, AA has like 5. Plus AA's only need like 8 shadow hours and no clinical experience. PA's need ~ 2,000 hours (to be competitive), more prerequisites, make less money starting out, and seem to work more in general. AA just seems too good to be true, there has to be some sort of catch. I'm sure it becomes really mundane or something, but I really enjoy watching surgeries take place, so I don't find it a bad thing. AA's just seem really rare compared to PA's, so it's hard to find answers to my questions.

[cemetra]

@scott079 how'd you make the switch? I'm currently still going for my undergrad, so I have a good 3 years left before deciding, but AA seems like the better choice. Maybe a little more mundane, but better pay, fewer prereqs, better pay, seems like a better life outside of work too, etc. I know PA's who say you can make about $150,000 after a good 5 years, but with AA, you could surpass or meet that right out the gate (it seems). I try not to let money be a primary factor in my decisions, but really?! More money, more time off, still helping patients, being in the OR, the same amount of time for the program, like... What's the catch here? I just wanna help people in surgeries. If I'm the one putting them to sleep and watching vitals and whatnot, that's still fine with me - especially if I'm making $30k more starting out than a PA. It just seems like a better work-life balance too. Can't really find any cons other than it being a little mundane from time to time, but I don't see that. I mean, let's say you work 10-hour shifts and have some minor surgeries on the schedule - most lasting 2 hours. You get the patient ready, sedate them, watch the procedure, take them back to their room, eat a quick meal, grab the next patient, do it again... Next thing you know, you're watching like 5 surgeries in a day! That doesn't seem boring to me! Or maybe you have a long 10-hour surgery that's going to take your whole day. Okay, it may be a little more mundane that day. Boo hoo. I'm making 6 figures a year to help save people's lives. I don't get it - is there some sort of catch here? Haha.