Do you still recommend people going to PA school? If so, why?

[Grinder993]

I am just curious.  I have been a PA for 13 years.  I went the extra mile after school and completed a residency.  I find myself long into my career, working in solo practice ER sites, doing the SAME job as the MD.  As a solo provider....for 1/3 the pay.    I find myself very aggravated with the profession, it's weak kneed leaders and general stagnation of pushing for it's rightful place among the medical cadre.  

I find myself bitter for having short changed myself by becoming a PA.  I was 30 at the time...it made sense to go the PA route, I felt I was too old for MD school at the time.   I was wrong.  

I have seen the overall dismissal the medical system has for us, from the attending MD to the specialist cussing you for calling them, to the administrators who don't feel anyone (MD, PA or NP) is anything more than a replaceable cog in a soul grinding machine called "Medicine".  

I now find myself when approached by staff who are considering going to PA school, telling them "don't".  You know, you get approached by the tech, or the paramedic who wants to ask you about becoming a PA.  I used to tell them "being a PA is great, blah, blah, blah..."  I have found over the last few years, that has stopped, now I tell them "don't do it."   I tell them that medicine is a nightmare that is only getting worse, we have a 3000% increase in administrators in medicine over the past 30 years, we are ruled by various BS metrics that rule our lives, everyone is miserable.  If you are going to be miserable, at least make the most money you can for it......"go to medical school".  

I believe any PA worth their salt who says they have NEVER regretted becoming a PA is lying to you and themselves.

So colleagues, I am curious, who still believes?  Why? 

[EMEDPA]

If I had life to do over again I would also do the MD/DO route. Sounds like my situation is similar to yours, but the docs I work with only make $15/hr more than I do. I am ok with that. I did the doctorate, but did not do a residency as there were none when I graduated. If I graduated from pa school today I would definitely do one.

[sas5814]

I am late in my career..maybe 6-7 years from semi retirement so I am in until the end. If I knew then what I know now I'd have gone into technology. If a computer makes you mad you beat it with a hammer and get another one.

[PAtoMD]

Still a student so this all should be taken with a grain of salt.

I wouldn’t and a lot of my classmates say if they could go back they wouldn’t do it again. 

 

I plan to apply to medical school and if that fails apply for a residency. Who knows if that happens though cause life has a way of changing things.

[Grinder993]

If I could do it over again I would have stuck with my original direction which was to be a pilot.  Fed Ex pilots make $300k/yr and only work about 10 days a month.  Not a bad gig!

[Jkarram]

Every doc I know tells prospective students to stay clear of med school. 

Take home message: working sucks, go back in time and be a trust fund baby. 

 

Edit: spelling 

[weezianna]

Have transitioned from full-time traditional employment to locums in the process towards retirement.  I have always loved the science and clinical aspect of medicine, and if I could turn the clock back 30 years would go to medical school and specialize.  PAs are unfortunately being bypassed for NPs not because of their skills, but independent status.

 

Saw a big billboard while driving out of Charleston, SC earlier this week:  "Cloverhealth.com is hiring Nurse Practitioners".  No mention of PAs.

[Joelseff]

I think practicing Medicine in general especially in today's environment and moreso Primary Care, can really grind you down.

I would not recommend it to people. Not just PA but MD/DO also. I think the investment/return ratio is not worth it in the end for both professions and I'm not talking about just money.

I would rather do something else to tell you the truth. What to do instead? That I dunno. Still trying to figure it out.

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[CAdamsPAC]

4 hours ago, Grinder993 said:

I am just curious.  I have been a PA for 13 years.  I went the extra mile after school and completed a residency.  I find myself long into my career, working in solo practice ER sites, doing the SAME job as the MD.  As a solo provider....for 1/3 the pay.    I find myself very aggravated with the profession, it's weak kneed leaders and general stagnation of pushing for it's rightful place among the medical cadre.  

I find myself bitter for having short changed myself by becoming a PA.  I was 30 at the time...it made sense to go the PA route, I felt I was too old for MD school at the time.   I was wrong.  

I have seen the overall dismissal the medical system has for us, from the attending MD to the specialist cussing you for calling them, to the administrators who don't feel anyone (MD, PA or NP) is anything more than a replaceable cog in a soul grinding machine called "Medicine".  

I now find myself when approached by staff who are considering going to PA school, telling them "don't".  You know, you get approached by the tech, or the paramedic who wants to ask you about becoming a PA.  I used to tell them "being a PA is great, blah, blah, blah..."  I have found over the last few years, that has stopped, now I tell them "don't do it."   I tell them that medicine is a nightmare that is only getting worse, we have a 3000% increase in administrators in medicine over the past 30 years, we are ruled by various BS metrics that rule our lives, everyone is miserable.  If you are going to be miserable, at least make the most money you can for it......"go to medical school".  

I believe any PA worth their salt who says they have NEVER regretted becoming a PA is lying to you and themselves.

So colleagues, I am curious, who still believes?  Why? 

 

1 hour ago, weezianna said:

Have transitioned from full-time traditional employment to locums in the process towards retirement.  I have always loved the science and clinical aspect of medicine, and if I could turn the clock back 30 years would go to medical school and specialize.  PAs are unfortunately being bypassed for NPs not because of their skills, but independent status.

 

Saw a big billboard while driving out of Charleston, SC earlier this week:  "Cloverhealth.com is hiring Nurse Practitioners".  No mention of PAs.

Coulda,woulda, shoulda..................It's The NP's fault! I've worked as a PA 30+ years  watched the "p**is envy" of NPs weasel it's way into the arena of what is now a business full of physicians who are most interested in being unburdened of mundane duties and making money. NPs have jumped onto the line of " we can do that and you don't have to answer for our actions" to meet this unspoken laziness of far too many physicians. The "leadership" of the PA professions has committed itself to passivity and going along to get along rather than forcefully advocating the  benefits of PA training  and clinical skills being in keeping with the medical model. I work anywhere from 150 to 1,000 miles from my SP so independent practice is a non starter for me. The physicians I work with hired me for my proven ability, not the letter on my rarely worn lab coat! I worked with an NP who told me she felt better about her family's safety when I was in town.

[EndBulbsOfMouse]

Grass is always greener...

[mgriffiths]

30 minutes ago, EndBulbsOfMouse said:

Grass is always greener...

this 1000x over...

[CAdamsPAC]

1 hour ago, EndBulbsOfMouse said:

Grass is always greener...

Over the septic tank!

 

[Joelseff]

Grass is always greener...

True. But sometimes your lawn can be full of dog $#!+

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[Grinder993]

I appreciate the responses, you guys have made me smile! 

"If you want to change the world, find someone to help you paddle." Adm. William H. McRaven
 

[hlj25950]

I’ve only been a PA for just over a year, so take that for what it’s worth.

Being a doctor, for me, is definitely NOT worth it. Those of you who think doctors have it so good are missing the point.

https://www.ncbi.nlm.nih.gov/m/pubmed/26599310/?i=19&from=physician%20satisfaction%20job&sort=[relevance]

“Of 68 publications reviewed, 29 met criteria and were categorized in a Job Characteristics Model. Most studies report a high degree of job satisfaction when autonomy, income, patient responsibility, physician support, and career advancement opportunities are surveyed. Age, sex, specialty, and occupational background are needed to understand the effect on job satisfaction. Quality of studies varies widely.”

https://www.ncbi.nlm.nih.gov/m/pubmed/29101932/?i=2&from=physician%20career%20satisfaction&sort=[relevance]

I’m telling you most physicians I know wouldn’t do it again. I’ve been married since undergrad to an ortho surgeon, and it influenced my decision not to do medical school. Physician residencies are hell beasts that cannot be compared to PA residencies or practice.

Physicians have higher liability. They have decreasing autonomy (due to hospitals buying them out and little to no choice in the matter) because they can’t negotiate favorable contracts with insurance companies and stay in business anymore. There are more administrators in medicine. Who know nothing about taking care of patients and just see $$$. Debt to go into physician practice is much greater.

On balance it was well worth going to PA school rather than medical school. Yes, there are definitely disadvantages, but at least we have some lateral mobility. Physicians do not. Not without doing another residency. We have the ability to practice in the field we want for the most part. Physicians have less ability to do this. For residencies, they are matched by a computer (if they match - there are fewer residencies than applicants). Some specialties are highly competitive and only the top 10% in classes and on boards need apply. So you wanted to do______? And if you don’t match or finish a residency? You cannot work as a physician.

I know several doctors who have committed suicide. I know a few who were not advanced in their residencies. A few were able to transfer to a new residency and start over in a completely different field, not their preferred field, and a few have jobs completely outside of medicine and are unable to pay their school debts, end up teaching Anatomy at a community college or something similar.

Even if you do make it through, the at a bare minimum, triple the training, is not always worth it. And often, wasn’t worth it. You miss out on life. You sacrifice a lot.

If you graduate, as a PA, however, and pass your PANCE? You can change fields if you really want to. It’s hard to change fields, no doubt, but you can without doing 3-10+ years of 80-120 hour work weeks. That is, if you can even rematch in a different field.

I’m not sorry I chose PA over med school. Are there things that are worse? Sure. Worth it to be a PA and not a MD/DO? Absolutely.

[UGoLong]

A question that can probably never be answered. Pick any career and you will find people heroically trying to get into it and people desperately trying to get out of it -- sometimes even the same people at different stages of their lives.

No career is perfect, no situation stays static, and no job can promise you that it will always be "good to you." At some point, it might be time to change to a different position or a different career. Try not to get bitter about it when the dynamics change (I've been there) and just always do what is best for you and your family.

[FiremedicMike]

Nontrad Pre PA/MD/DO/NP student here..

For the mid-level position, if you could do it over again but it was 2018 with the current climate, would you still choose PA over NP? 

I speak as someone who will, at the time of matriculation, have 25 years of experience as a firefighter/paramedic/EMS Instructor, which IMHO is more than enough to compensate for a lack of RN experience if I were to venture into a direct entry NP program.  My question for you guys is, why would I choose PA over NP?  As I look at the prerequisite course load for both programs, the time investment while in both programs, and then the practice environment post graduation (which appears to be identical for both pathways), I struggle to find a reason to go the PA route over the NP route.

 

I truly and honestly didn't post this to start an NP vs PA war, but it is truly a decision that I struggle with.  UGoLong and I have had coffee together and can attest to my genuine interest in this topic.  I know his thoughts, but I'd love to hear from the rest of you!

[hlj25950]

Nontrad Pre PA/MD/DO/NP student here..
For the mid-level position, if you could do it over again but it was 2018 with the current climate, would you still choose PA over NP? 
I speak as someone who will, at the time of matriculation, have 25 years of experience as a firefighter/paramedic/EMS Instructor, which IMHO is more than enough to compensate for a lack of RN experience if I were to venture into a direct entry NP program.  My question for you guys is, why would I choose PA over NP?  As I look at the prerequisite course load for both programs, the time investment while in both programs, and then the practice environment post graduation (which appears to be identical for both pathways), I struggle to find a reason to go the PA route over the NP route.
 
I truly and honestly didn't post this to start an NP vs PA war, but it is truly a decision that I struggle with.  UGoLong and I have had coffee together and can attest to my genuine interest in this topic.  I know his thoughts, but I'd love to hear from the rest of you!

Depends on specialty you see yourself in. Some are easier as a PA (surgical, emergency, procedure heavy), and some are better for NP (primary care), some far superior or only available to NP with specialized tracks (anesthesia -CRNA, or Obstetrics/Gynecology (Nurse Midwife). You can do OB as a PA, but it’s much harder. You can’t really do anesthesia as a PA. You can do surgery or ER as an NP, but there is bias there (definitely able to overcome this with the right background).

I preferred becoming a PA, just based on training and my track. Had I already had a BSN? I’d probably have gone the NP route. It’s a fact that they have a better lobby. Ours it crap.

[FiremedicMike]

3 minutes ago, hlj25950 said:

 

Depends on specialty you see yourself in. Some are easier as a PA (surgical, emergency, procedure heavy), and some are better for NP (primary care), some far superior or only available to NP with specialized tracks (anesthesia -CRNA, or Obstetrics/Gynecology (Nurse Midwife). You can do OB as a PA, but it’s much harder. You can’t really do anesthesia as a PA. You can do surgery or ER as an NP, but there is bias there (definitely able to overcome this with the right background).

I preferred becoming a PA, just based on training and my track. Had I already had a BSN? I’d probably have gone the NP route. It’s a fact that they have a better lobby. Ours it crap.

Thanks for the response.  If it helps, my current goal is to work on an inpatient medicine team with general hospitalist work and procedures in a semi-rural facility.

 

[Guest HanSolo]

18 minutes ago, FiremedicMike said:

Nontrad Pre PA/MD/DO/NP student here..

For the mid-level position, if you could do it over again but it was 2018 with the current climate, would you still choose PA over NP? 

I speak as someone who will, at the time of matriculation, have 25 years of experience as a firefighter/paramedic/EMS Instructor, which IMHO is more than enough to compensate for a lack of RN experience if I were to venture into a direct entry NP program.  My question for you guys is, why would I choose PA over NP?  As I look at the prerequisite course load for both programs, the time investment while in both programs, and then the practice environment post graduation (which appears to be identical for both pathways), I struggle to find a reason to go the PA route over the NP route.

 

I truly and honestly didn't post this to start an NP vs PA war, but it is truly a decision that I struggle with.  UGoLong and I have had coffee together and can attest to my genuine interest in this topic.  I know his thoughts, but I'd love to hear from the rest of you!

Sounds like you have already sat down with an excel spreadsheet, whiteboard or whatever and analyzed the opportunity cost of the situation. Will you have to move? Personally, I would strike the best balance between what is best for you and your family. For example, if there is a local NP program and not PA, then the choice seems pretty clear (or vice versa). 

In the end, I don't think a lot of people care about the letters behind your name as long as you are competent and respectful. The internet is fully of the good, the bad, and the ugly. Best of luck with your decision. 

[hlj25950]

Very true! It should be based on what is best for you and family. Also, in general, you can probably work during an NP program, and you cannot work during a PA program.

 

[thinkertdm]

I would recommend doing whatever makes you happy.  In the end, all that is left are either happy memories with your family, happy memories of patients who lived, patients who remember the person who changed their lives; or the opposite: a bitter, resentful person, who hates what life has served 'em, who hates doing what they do, and hates knowing that they have to do it or else their family (that they won't see anyways) won't eat.

Bills will always be there.  Your family won't.  This time that you have, won't.  Spend each day knowing that you woke up, and that someone is glad that you did.  To hell with Comcast bill collectors calling, your crappy car; know that your wife, your son, the guy dying of liver cancer, had their life changed because of you.

PA vs MD vs NP?  Who cares?  You change lives either way. 

I went walking downtown DC on Thanksgiving day and had very low blood sugar.  There was literally nothing open, no stores, no convenience places, nothing.  My wife and I were looking for a Metro, and stopped to talk to a homeless couple.  They gave me a pepsi to drink.  A homeless couple gave me a pepsi.  So now, I pay it forward, because I can't pay back everyone who got me here. 

If you are miserable, its your own damn fault.

[sas5814]

LOL! I agree wholeheartedly. I have gotten a bit older. In the last year both my brothers, my cousin, and one of my oldest friends have died. Another of my oldest and dearest is losing the battle to prostate cancer. I am so much less interested in money than I am in time. I want time with friends and family and that doesn't cost me a nickle.

The UC pays me well but the hours blow. They are talking about going to 3 12's a week and I am holding my breath. To quote an old platoon Sgt...I can stand on my head in a mud puddle 3 days a week.

[EMEDPA]

discussions of pa vs md always seem to focus on the residency and claim that it is hell for the docs. guess what? A lot of residencies are cush after the first year with night float coverage, lots of electives, opportunities to moonlight, etc

most of the docs I know are very happy as physicians and would not have it any other way. the docs who tend to be miserable are the ones who do the really long residencies and/or fellowships. these are mostly surgical folks. EM and FP are both 3 years. yes, internship is rough with lots of hospital time, off service rotations, call, etc, but it is 1 year. As Scott said above, you can do anything intense for a short period of time. 80 hr weeks? I frequently do 72 hr + weeks now 22 years out of school. this week I am doing 96 hours (4 x 24s).  After pgy-1, most of pgy2 and 3 for fp is cake. I have worked at 2 facilities with fp residencies and was consistently in the hospital more as a pa than the pgy2 and 3 fp residents. After pgy-1, most of em is shift work, typically 18-20 shifts/month in the ER. sounds pretty similar to the EM schedule for a new grad PA. I understand there are specific reasons folks choose pa over md, like loans, anticipated life trajectory, kids, family, etc. Many of these are valid reasons. "residency is too hard" should not be one of those reasons in most cases outside of the surgical specialties.

[Joelseff]

[mention=74630]hlj25950[/mention]

 

I agree mostly with this except for the part about NP being more suited to Primary Care than we are. I disagree. PA education is much more thorough in preparing one for Primary Care in my opinion. Primary care isn't just sniffles and punting to specialists. I think Primary Care requires a lot of depth and breadth that most specialties don't cover/require (say ortho or derm for instance) and it can be a minefield from a medical standpoint so you need to know your stuff.

 

I think if you meant that NPs have a better political position which gives them an advantage in more job postings etc in Primary care then you may be right, but as far as medical acumen, I disagree an NP is better suited to Primary Care.

 

Remember PA education is primary care and though it may seem we have as a profession in general, trended away from that (prob because of less Private Primary care offices nowadays so the whole finding an SP thing has become more problematic? And maybe more advertising for NPs vs PAs in PC job listing? I dunno) Primary Care PAs (yes we still exist) are not as rare as it is portrayed to be (mostly here on the forum). According to AAPA, Primary Care PAs still make up a large part (if not the majority) of practicing PAs if I remember the source correctly.

 

I agree with the rest though.

 

But I still don't recommend medicine as a profession to folks who ask me anymore [emoji16]

 

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