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Are you happy as a PA?


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10 minutes ago, Joelseff said:

For the benefit of the uninitiated posters this was tongue in cheek as Emed and the other old timers here know these "benefits" of being a PA are going bye bye

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spending more time was never real and lateral mobility is having death throes even now. try to switch from EM to surgery. not going to happen without a residency in 2018 unless all you are doing is wound checks and holding retractors. you will not be able to credential for any intraoperative procedures or any invasive procedures on the floor. We had a PA who was a licensed u/s tech and had > 250 documented successful thoracenteis procedures. (more than any doc on staff). it took a year before he could get credentialed to do u/s and NEVER got credentialed for thoracentesis. He quit.

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7 minutes ago, EMEDPA said:

. try to switch from EM to surgery. not going to happen without a residency in 2018 unless all you are doing is wound checks and holding retractors. you will not be able to credential for any intraoperative procedures or any invasive procedures on the floor. We had a PA who was a licensed u/s tech and had > 250 documented successful thoracenteis procedures. (more than any doc on staff). it took a year before he could get credentialed to do u/s and NEVER got credentialed for thoracentesis. He quit.

Greatly location dependent.  Great friend just went from neuro to interventional rads, others from ortho to EM, and from EM to FP.  

Is lateral specialization going away? Yeah, probably, but not dead yet.

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ortho to em or ortho to fast track?

anyone can transition to primary care by definition. there is a huge need and low salaries in general so they just want someone with a pulse. Neuro to IR I admist is impressive. we almost got an IR PA to come work em a few years(10) ago at one of my trauma ctr jobs until they offered her a 60k raise not to leave.

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1 hour ago, Boatswain2PA said:

Im not making assumptions, just asking WHY.

WHY do you think PA is a better fit?

If I was attacking you....you would know it.  

You "could have gone to medical school"? You haven't passed the prerequisites, and no mention of your MCAT scores or acceptance letter...not sure you should say you "could have gone to medical school." 

 

So, back to my initial response.  WHY were you not interested in medical school? Why is PA so "perfect" for you?

I said I did not take some of the prerequisites, I didn’t say I failed anything. I never failed a course in college. I was initially a math major, but then decided on PA. It was never, “oh should I do medical school instead?” It was, “wow, I’d rather be a PA than anything else.” And I loved math. I wrote my whole personal statement on my journey of deciding to become a PA. I’m not going to explain all that here. Why would I take the MCAT if medical school was never something I was interested in or planned on pursing? Makes no sense. You seem unhappy with your decision to become a PA, but don’t go putting that energy on others. There are other ways to say, “yeah PA seems cool, but here’s why MD/DO is a better option” 

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OP, I was a very similar age to you when I matriculated into my program. I was very excited and optimistic to take on PA school and become a PA. However, about halfway through school I became apathetic and desiring more. I became worried about my career choice, competency, and upward mobility. I toyed with the idea of residency until it was made clear to me I desired a residency because I wanted to operate as physician. Eventually I decided medical school was the thing for me. Most of my classmates do not have these same sentiments. I have only spoken to a few that do. I do truly believe that the PA career is not meant for young applicants like you and I. It was never designed for it. 

 

Besr of luck to you and congratulations on your acceptance.

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16 minutes ago, PAsPreMed said:

OP, I was a very similar age to you when I matriculated into my program. I was very excited and optimistic to take on PA school and become a PA. However, about halfway through school I became apathetic and desiring more. I became worried about my career choice, competency, and upward mobility. I toyed with the idea of residency until it was made clear to me I desired a residency because I wanted to operate as physician. Eventually I decided medical school was the thing for me. Most of my classmates do not have these same sentiments. I have only spoken to a few that do. I do truly believe that the PA career is not meant for young applicants like you and I. It was never designed for it. 

 

Besr of luck to you and congratulations on your acceptance.

I appreciate the honesty. Thank you, and best of luck to you as well

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1 hour ago, Boatswain2PA said:

You still haven't answered my questions.  WHY were you not interested in med school?  And WHY do you think PA is "perfect" for you?

I did answer it. I said I wrote it in my personal statement and that I was not going to explain that here. I got what I wanted out of this post, the honest part of the profession from PAs who enjoy being a PA and PAs who wish they were physicians. Good luck to you! :)

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I do EM, so sometimes I do feel I make a difference.  I like the short feedback loop of EM with relatively rapid turnaround on diagnostics and the ability to see the effect of interventions.  Plus, I like procedures.  In EM patients always go away: they get better, they get worse, they go home, they get admitted, but they always go away.

I do envy the EM docs training and knowledge, but this is my 3rd career, so it was the right trade-off for time invested vs rate of return.  Had I started this path 10 years earlier I would have gone the DO route.  I'm happy with my choice and working on my knowledge and skills as I go.  I've been fortunate in my jobs with the opportunities to learn and now that I'm doing solo overnight coverage with a doc on call that I'm growing my individual responsibility too.

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Two years in, am I happy? Yes. I like my job. I do night-time cross coverage with responsibility for 80-100 beds or so with usually between 2-4 admissions and/or consults for ortho nightly. I feel like I get to make differences in peoples' lives and I feel like my  job is challenging. I work with two diff docs (neither is officially my SP), and I freaking love one and I enjoy the other although she can be a bit difficult to work with at times.

But.

I do have concern for my ability to be happy long term as a PA. Already at the two year point, I'm finding myself frustrated with a few things that I suspect will only grow with time. I would not have expected to find myself in this position, as I thought that PA was a great choice for me as you clearly do for you. I was older than you coming in, I think- not as old as some who've gone to PA school, but I perceived myself as old enough at 30 that I felt like med school was a bigger time investment than I wanted to make when I hoped to start a family before too long. I also liked the lateral mobility which has been discussed by others on this thread as becoming less common over time. Now I'm finding that I don't like that my ability to perform a procedure, regardless of how well trained and experienced I am in said procedure, is tied to my SP's ability to perform it. I don't like that my attending physician can sign over my note as if she did it herself (it's been brought to my attention recently that this particular doc may be doing this in a fashion that is technically not legal but that's neither here nor there, there is a way it can be done legally) with a few changes. I don't like that when my group was recently absorbed by another group, all our docs got to negotiate huge raises and work less, whereas I got told that "we don't negotiate with APCs, you just get paid the same transparent amount as anyone else in your job" and ended up with a pay cut. I realize some of these things are the result of where I work as opposed to a rule for the profession but from what I have heard from others, these are not uncommon problems for PAs. 

I think the important thing to ask yourself is if you're going to be okay with being tied to a SP- unless/until we gain  more independence in practice- and then ask yourself again. Because I didn't think I would mind and I find myself minding. Now my goal is to follow in @EMEDPA 's footsteps... so I will likely try to do an EM PA residency. 

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I think a lot of it depends on your life situation. I'm in my first year now and I have some days where I struggle with the PA vs med school choice. I anticipate that the feeling won't completely go away in the future, either. If I were 23 and didn't have a family (wife, kids etc) I think I'd have given med school a much harder look. As it were, I didn't want to be an absent father and starting my career as an attending at almost age 40. I didn't want to have to move around for med school, residency, fellowship etc. The list goes on and on for my life situation as to why MD wasn't the right choice. Ultimately I chose to pick my job as just a job and not my identity. I'd rather be "Boli the husband and dad who works as a PA" than "Boli the distinguished physician who also has a family" (keep in mind your mileage may vary and lots of docs I know have great home lives). It's damn hard to have and raise kids when you're in school and training throughout your 20s and 30s. 

PA has some awesome advantages which make it a great career but like I said, if I were 6 years younger with fewer obligations and applying I'd probably give med school a shot.

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49 minutes ago, boli said:

I think a lot of it depends on your life situation. I'm in my first year now and I have some days where I struggle with the PA vs med school choice. I anticipate that the feeling won't completely go away in the future, either. If I were 23 and didn't have a family (wife, kids etc) I think I'd have given med school a much harder look. As it were, I didn't want to be an absent father and starting my career as an attending at almost age 40. I didn't want to have to move around for med school, residency, fellowship etc. The list goes on and on for my life situation as to why MD wasn't the right choice. Ultimately I chose to pick my job as just a job and not my identity. I'd rather be "Boli the husband and dad who works as a PA" than "Boli the distinguished physician who also has a family" (keep in mind your mileage may vary and lots of docs I know have great home lives). It's damn hard to have and raise kids when you're in school and training throughout your 20s and 30s. 

PA has some awesome advantages which make it a great career but like I said, if I were 6 years younger with fewer obligations and applying I'd probably give med school a shot.

sounds like you made the right choices for you. I am not just wired that way. For good or bad, I am Emedpa, the "distinguished" PA, who also is a husband and father. Given that, med school would have been the best choice for me.

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1 hour ago, boli said:

I think a lot of it depends on your life situation. I'm in my first year now and I have some days where I struggle with the PA vs med school choice. I anticipate that the feeling won't completely go away in the future, either. If I were 23 and didn't have a family (wife, kids etc) I think I'd have given med school a much harder look. As it were, I didn't want to be an absent father and starting my career as an attending at almost age 40. I didn't want to have to move around for med school, residency, fellowship etc. The list goes on and on for my life situation as to why MD wasn't the right choice. Ultimately I chose to pick my job as just a job and not my identity. I'd rather be "Boli the husband and dad who works as a PA" than "Boli the distinguished physician who also has a family" (keep in mind your mileage may vary and lots of docs I know have great home lives). It's damn hard to have and raise kids when you're in school and training throughout your 20s and 30s. 

PA has some awesome advantages which make it a great career but like I said, if I were 6 years younger with fewer obligations and applying I'd probably give med school a shot.

This is exactly why I have decided on PA (just got accepted for next year). I love medicine and my career is important to me, but it is not my first priority and will always take a back seat to my family and my role as a husband and father. 

I know there will be downsides to PA vs MD/DO, but for me the extra time in training and the sacrifice of more precious years while my kids are young is just not worth it to me. 

That being said, just like boli, if I were 6-8years younger and single things would probably be different and I think young applicants that are single or don't have/want kids right now should take a long hard look at med school instead.

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It depends on what you want. If you are happy seeing patients but not being the "super one in charge with the final say" aka the doc, then do PA.; If you're not passionate about med school then I think it would be miserable to go. Me personally, I like being able to bounce things off the docs I work with, and I make a very decent salary and graduated 5 years ago, and am in a position where I feel respected. I am happy.

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As a med student, there are always pros and cons... If you are going to work a crap ton or are very invested in medicine then I would probably go MD, but if you mostly want to have a good job in order to be able to provide and spend time with your family then I would have to say PA school.

Gotta remember that most students take 2 years to get into MD school, then 1st year, then research and clinical experience during the summer, then 2nd year and studying for step, then 3rd year plus research plus step 2 CS and CK, then 4th year plus interviews and the match, then 3-4 years more (EM) of working 22 shifts a month for about 55k a year..... Yeah the payoff is great after that, but most will be 31-32 at that point, where big family decisions have to be made.

If the above isn't for you then I think PA school would probably be better. Hit the ground running at age 25... That sounds pretty good right about now lol

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23 minutes ago, JOhnny888 said:

If the above isn't for you then I think PA school would probably be better. Hit the ground running at age 25... That sounds pretty good right about now lol

Except the ideal candidate for PA school has several years of HCE before they apply. Avg age in my class was 35. At 27, I was one of the youngest in my class, but had 10 years of ER tech and paramedic experience at that point. 

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25 minutes ago, EMEDPA said:

Except the ideal candidate for PA school has several years of HCE before they apply. Avg age in my class was 35. At 27, I was one of the youngest in my class, but had 10 years of ER tech and paramedic experience at that point. 

Definitely, but that is not the average student anymore. The PA school in the same city as my med school has an average age of 24 (only like 3 ppl fit the ideal candidate definition). Most are a year out of college. Thats gotta be tempting to be pulling 100k as a 25-26 year old.. 

We also have 3 ppl in my class that are pretty old with extensive HCE. 

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7 minutes ago, JOhnny888 said:

Definitely, but that is not the average student anymore. The PA school in the same city as my med school has an average age of 24 (only like 3 ppl fit the ideal candidate definition). Most are a year out of college. Thats gotta be tempting to be pulling 100k as a 25-26 year old.. 

We also have 3 ppl in my class that are pretty old with extensive HCE. 

yup, I have seen lots of younger PA students. I mostly precept for U.WA/Medex, and they tend to have an older class with lots of ex-military folks, etc. 

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