Is Medical school worth it AFTER becoming a PA?

Yasuo · August 12, 2020

Should I go back to Medical school AFTER becoming a PA?

Specialties interested in: Internal or Emergency Medicine

Here are my personal thoughts:

I don't like to disparage my profession, but the way we learned medicine was through memorization of algorithms and buzz words. We were not taught the basics of science from a molecular level working upwards. We basically skipped step 1 and went straight into step 2 clinical knowledge. Doctors can see and understand things we cannot. And make connections that we cannot. I think this is what I am craving for. To be that kind of an “expert.” To understand medicine at that level and solve complex cases. I think the funny stereotypical word for this is “mental masturbation” or “intellectually stimulating” haha. I have the personality type of being the best in whatever I do. I feel limited in that sense as a PA.

Financially, I would say I am kind of lucky. I wouldn’t normally tell this to people, but just to give you guys an idea of my situation. I actually don’t have any loans or interests at the moment after PA school. I paid out of pocket. But I was given some personal loans from close families and friends. I do have to pay them back eventually, but there is no time limit. And they would understand if I decide to pursue medical school. I would still have to take the MCAT, apply, do interviews, and then start the following year (this could take 2-3 years; here I could work as a full time PA and save money for medical school). The medical schools in my state are $100k for 4 years. Which is not bad compared to the crazy $200-400k type of other medical schools.

For family life, wouldn’t it still be possible to have? Instead of working 8 hours a day, I would be studying or going to lectures. And then spend time with my family. Especially since I am not a typical pre-med student. I will be entering with a stronger background knowledge from PA school. However I do understand that the residency years will take a huge toll on my work/life balance for 3 years. (My mom or future wife would still have an income during the 4 years of medical school).

But at the end of it all, won’t I truly be knowledgeable in a field of medicine, from basics to advanced. With the reward of earning a higher income and becoming a doctor (not what I’m going for, but still a benefit). I will be done around age 35 and can work 30 more years until 65. Won’t the money gain as a doctor in that time cover any expenses I had? And then be able to teach the next generation as well, confidently. I have a desire to teach as a professor at PA or MD/DO programs. And precept as well.

This is my current thought process, BUT if you guys think that I am delusional or crazy, please call me out on it! Give me reasons why staying as a PA from age 26 will be better for my life in the long-run. And to not make the mistake of going to medical school for 7 years, with unnecessary stress. I want to hear both sides and arguments really well.

How different is the autonomy in internal or emergency medicine between PA and MD/DO? Can I learn step 1 on my own while working as a PA, and be just as knowledgeable and happy? Or is the in-depth training of medical schools and residencies unmatched? And no amount of clinical experience as a PA can ever replace that? (I have my own thoughts of course since I have done clinical rotations, I just want to hear from what you guys think).

***Here are some more of my thoughts that I just private messaged someone:***

Thank you so much for replying, I really need guidance in my life. I am confused and don't know WHAT path is actually WORTH taking.

I love medicine. I have grown super passionate about it. I also love academia. I watch a lot of medical school vlogs and wish I went through the rigorous schooling like they did. PA school felt like a joke to me. It was mainly memorizing buzz words, without understanding the "why's".

Now, I know I can learn the why's using third party resources on my own - like sketchymedical, boards and beyond, pathoma, premade anki decks, etc. However, if I am going to do that, why not do it through medical school and get rewarded with prestige, money, and autonomy?

But that does come with its cons - such as a losing lost income as a PA, family time, and basically life. For 7 years.

I am interested in Internal medicine (hospitalist) or Emergency Medicine. What I want to really know is if there is a huge difference in autonomy, day-to-day job/tasks, etc. Because if it's 90% of the same job, then I am not sure if 7 years of medical school is worth it for me. I know people recommend PA to MD if you want to go into either surgery or a specialization of some sort.

Basically, is 7 years of medical school worth it for me (I am single and 26 years old; I only need the MCAT to most likely get into this DO program in my home city; this way I can be with family and friends and not miss out on life events). It seems like a fun journey to me, something that I would look forward to.

But there is this other easier, more convenient, and relaxing path - which is to remain as a PA and practice medicine. Earning a six figure salary. Living life. And also studying step 1 material with the resources I mentioned earlier.

*sigh* Do you see my dilemma here. Like what is the right path for me - in terms of happiness, life, money, etc.

If I were to redo my years of schooling, I would 100% choose medical school. But because I finished PA school and am interested in specialties that might not be that different as a doctor, is it worth it? Because I do realize I will have to go through numerous standardized examinations - MCAT, Step 1, Step 2 CK, Step 3 CS, and residency boards. Also the stress of interviews, applications (both initial and for residency), research papers, etc.

Or will I always regret not going back for medical school?

Edited August 12, 2020 by SouthUStudent

KaiteKakes · August 12, 2020

NOOOOO. I didn't even read your full post, but no. If you want to be a PA, be a PA. If you want to be an MD, be and MD.

August 12, 2020

I read everything until the halfway point, and stopped myself.

I really can't speak on work life balance at all because i'm not even a PA student yet. However, the best advice I got from a DO was "if PA is your second pick, then don't do it - and vice versa" (in the context of a similar crisis where I couldn't bear family pressures making me switch from PA to MD/DO). Basically, you'll always have a glimmer of regret if you don't do it.

If it's the prereqs that will take you longer, there are online ones. There are also MD programs, like Hofstra (where I went for my MPH/Post bacc) where they don't have a set pre req list. If it's beyond the whole mental stimulation thing, there's also the DSMC option after PA school to get the "doctor" title for an extra year of schooling (lynchburg has a good one).

If you end up trying to go back to do MD/DO out of regret that you're already forseeing, I feel like you'd be spending even MORE time in school redoing what you know + a little more.

KuchiKopi · August 12, 2020

If it is what you want then do it. There are even some PA to DO programs..i think LECOM has one. There's probably MD ones as well.

Edited August 12, 2020 by Kirby219

AnchorandCaduceus · August 12, 2020

Im not sure if you are a still a student or a new grad. But sounds like you have doubts in your current path. It also sounds like you have not traveled long enough to fully explore the PA field. If you really want to ‘master’ medicine (a very specific part of medicine), the MD path is the way to go. We need more physicians! Our name (Assistant) says it all but a lot of colleagues has always seen this as a bad thing. We need to encourage and support those who may be working with in the future. Our profession would not exist without them.
Our profession however is unique and I have taken advantage of this. After getting a thorough education in the vast field of medicine, we are pretty a Swiss army knife of the medical field. We can jump around from each type of medical field. I have worked in primary care, surgery, pharma, mental health, correctional health, international clinical trials, and disaster relief. It’s like I’m doing my clinical rotations throughout my career. I guess I get bored too easily and enjoy learning the different fields of medicine.

**EMEDPA** · August 12, 2020

3 yr PA to DO. No Mcat.

https://lecom.edu/academics/the-college-of-medicine/accelerated-physician-assistant-pathway/

Would still do it if I was single after 23 years as a PA.

chiaroscuro27 · August 12, 2020

It sounds like you have your mind made up, and if you truly want to be a physician I say go for it! I agree, there are loopholes in our training when compared to that of our physician colleagues. The good news is you can fill those loopholes...but it will take some time! Just because you've graduated from PA school doesn't mean you stop reading, learning and training. There are PAs I work with that outperform our physician colleagues. It's not necessarily the degree that gives you the knowledge. It's a voracious appetite for information and a desire to perform at the highest level possible. That is what propels you to continue to read and study year after year. You don't need MD behind your name to do that. Now if you want to practice independently without supervision, or if you want to be called doctor in the clinical setting you'll have to go to medical school. And just be honest with yourself. Because at the end of the day you want to be happy with the decision you've made. I've always wanted to pursue doctoral level education, in part because I want to achieve a certain level of scholarship, but I want to be a doctor...period. I want that level of expertise in a field of study. I'm honest about that with myself. I have no interest in being a physician; my work as a PA, especially in the setting I work in, allows me to do all the things I could ever want to do as a PA, all while freeing me up to do the millions of other things I do like own and operate two businesses, volunteer, work professionally as an artist, serve on the BOD at a local non-profit, etc. My physician colleagues could never do all of this. They are married to medicine in a sense. Some of us would say our world revolves around medicine. I'm not in that camp. I love medicine but I love so many other things, and being a PA gives me the best of all worlds. Think about what you want your life to look like and go from there. No answer is the wrong answer, unless you are not being honest with yourself. You are young and you have time to think on it.

Good luck to you!

**LT_Oneal_PAC** · August 12, 2020

45 minutes ago, EMEDPA said:

3 yr PA to DO. No Mcat.

https://lecom.edu/academics/the-college-of-medicine/accelerated-physician-assistant-pathway/

Would still do it if I was single after 23 years as a PA.

I would do it for the extra money only now and more job opportunities. I do everything I’ve ever wanted after residency.

ohiovolffemtp · August 12, 2020

If you want to do EM: as a PA either through a residency or extensive OJT and self directed learning you can do pretty close to full scope EM in a very few very special locations, making probably 35-45% of what a EM doc (boarded or highly experienced) makes. Most EM PA's make less and don't have near that level of skill or responsibility. You'll be searching and fighting for those few unique opportunities. As an EM boarded doc, you'll be starting by default at the goal line we strive for, making 2X or more what we make. To get there you will have spent 3-4 (in most cases 4) years in medical school and 3-4 years in an EM residency. You will have way more knowledge: some because of the basic sciences in the 1st part of medical school, way more because of the guided experiences including off-shift rotations in residency. Most EM docs I know say that 90%+ of what they know they learned in residency. Lot's of lost income, strain on relationships, etc. Only you can determine if the increased rewards are worth the up-front investment.

Why did chose PA: my age. I started PA school at 53. It was the right choice given my life path. Had that path brought me to medicine 10 or more years earlier, I would have pursued DO school.

You're way younger. It's up to you to decide if you want to make that trade-off. There are posters here who have gone to medical school and some are now practicing physicians.

PAtoMD · August 12, 2020

Yasuo · August 12, 2020

8 hours ago, PAtoMD said:

Hahaha woah are you already on this path? Would you mind sharing your background and why you decided to go back for medical school after becoming a PA? What is your thought process? What are you benefiting? What are you sacrificing?

Yasuo · August 12, 2020

Thank you for the in-depth responses guys! I am reading them all and taking them into consideration. Can I ask for input on the day-to-day job differences as a PA vs MD/DO in internal or emergency medicine? (If there are any).

**EMEDPA** · August 12, 2020

9 hours ago, PAtoMD said:

Dad?

**EMEDPA** · August 12, 2020

48 minutes ago, SouthUStudent said:

Thank you for the in-depth responses guys! I am reading them all and taking them into consideration. Can I ask for input on the day-to-day job differences as a PA vs MD/DO in internal or emergency medicine? (If there are any).

I work at 4 EDs. At 2, I am solo and completely independent and interchangeable with an ED physician.

At the other two, I work double coverage with ER boarded docs seeing every other pt. By state law, a physician needs to be "involved" in every real trauma. What that amounts to is I say, " Hey Scott, I am transferring the trauma in room 5, they have a liver lac". and he says "ok".

In my note I write " case d/w ED attending physician who is aware of pt and agrees with the assessment and plan. "

He makes more than twice my salary and is more than a decade younger than I am. would I trade with him? you bet.

Yasuo · August 12, 2020

Here are some more of my thoughts that I just private messaged someone: