Interesting discussion with my CP

[Acebecker]

My CP is an internist.  She is an excellent teacher so has many students who are pre-med, MS1, and MS3s.  One of her pre-med students was told by another physician (not my CP) not to go to medical school because PA school is essentially the same and in primary care PAs will replace MDs within the next 10 years.  My CP disagrees with that, as do I - I always tell my pre-PA students to consider medical school if they are young and don't have a bunch of commitments (family, kids, debt, etc).  I would not ever say, "Don't go to PA school."  I love my job, love what I do.  But for some people medical school is better.

At any rate, my CP has asked me to discuss this with the pre-med student in question.  The interesting part is that my CP also believes that medical school is better because of the handholding in residency.  She says that PAs are expected to hit the ground running from day one with little or no supervision and that it's really hard to do that.  I did clarify with her that it is ingrained in us that we need to ask when we are not comfortable or don't know for sure what to do.  I just thought it was interesting.

[sas5814]

wow...interesting. I don't think we are going to "replace" physicians in primary care but I do think we are going to be performing the bulk of primary care for the forseeable future. Perhaps she meant that

Like you I think different folks have different desires and goals and values so some should go to med school and some to PA school.

[Joelseff]

I don't think we are going to replace PCPs any time soon... NPs might though in some areas.

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[lkth487]

I do think there is a role for physicians in primary care.  I'm in peds, and I am not going into primary care, but in the clinic I work at, the PAs/NPs see patients completely independently but usually 0-2 times per day, they'll come and talk to an attending physician about a case that's usual or they aren't sure about.  I think that model works.  It's hard for me to believe (and maybe I am wrong) that all those rotations and specific learning I did in PICU, CICU, NICU, cardiology, hematology, oncology, transplant, endocrine, rheumatology, nephrology etc are completely useless and I could get the same competence via purely on the job training.

To answer the thrust of your question though - I think it's important to think about your specialty choice and how sure you are about it.  Sure, if you're totally gung ho about primary care or something like that, it's one thing.  But 90%+ people during medical school change their mind.  Let's say you do medical school and fall in love with radiology...or pathology...or interventional neuroradiology, or pediatric BMT...or pediatric cardiothoracic surgery, etc.  In some of those fields, you have essentially complete independence, in others you have almost no autonomy, and in others still there are essentially no (or very rare, like in pathology or radiology) jobs for PAs.  So you have to keep that in mind too.

I think they are both excellent fields and there are pros and cons to each.  But I do not believe that they are 100% interchangeable in every situation or specialty.