Jump to content

Recommended Posts

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 by SouthUStudent
Link to post
Share on other sites

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. 

 

Link to post
Share on other sites

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. 

Link to post
Share on other sites

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!

  • Like 3
Link to post
Share on other sites
  • Moderator
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.

  • Like 2
  • Upvote 1
Link to post
Share on other sites

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.

  • Like 1
  • Upvote 1
Link to post
Share on other sites
8 hours ago, PAtoMD said:

image.gif

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? 

Link to post
Share on other sites
  • Moderator
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. 

  • Like 2
Link to post
Share on other sites

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 by SouthUStudent
Link to post
Share on other sites

I started out in a rural ED straight out of PA school.  I had to drive 1 1/2 hours one way to get there and I was scared to death during every shift, but it was the best decision I made coming out of school. I was there for almost three years before we moved, and then  I took a job in a larger ED and found out quickly that I had been spoiled.  In the rural ED I had a lot of independence but a lot of support. I had great docs and great guidance.  In larger facilities I felt like a cog in a wheel, relegated to fast track to move bodies in and out as fast as possible and I knew my skill set was much broader than that. I'm now back in a smaller ER and I'm currently looking for prn work at another rural ED.  I am contracted to work 9 days a month; I have the flexibility to take more shifts..or not. This gives me great freedom but ensures that I make the salary I want.  My docs are great and we all work together as a team.  I consult with them on patients as needed, and they often ask my opinion about how to proceed with patients. There is a lot of mutual respect.

So I share all of that to say finding your place in medicine is just as important as your title.  You can be a great physician and be miserable if you haven't rooted yourself in the right place.  The same goes with PAs; it is important that we choose our specialties and our work environments very, very carefully.  As a ED PA I'm able to carve out the life I want.  The ED lends itself very well to those of us who wear many hats outside of medicine.  There are months when I feel like working a bit more, and there are other months (pre-pandemic) where I'm globetrotting for three out of the four weeks.  My best advice: live your life by design as much as you can.  Decide now what is most important to you, make a plan, work the plan, and keep working the plan until you've achieved the intended goal.  Don't chase money or titles; money is a tool to buy you necessities and experiences, and as a PA you will always have the means to make decent money.  Chase happiness, comfort, contentment.  Put your focus there and I think it will be easier for you to make the right decision.  

 

 

Edited by chiaroscuro27
  • Like 3
  • Upvote 1
Link to post
Share on other sites
  • Moderator
14 minutes ago, chiaroscuro27 said:

I started out in a rural ED straight out of PA school.  I had to drive 1 1/2 hours one way to get there and I was scared to death during every shift, but it was the best decision I made coming out of school. I was there for almost three years before we moved, and then  I took a job in a larger ED and found out quickly that I had been spoiled.  In the rural ED I had a lot of independence but a lot of support. I had great docs and great guidance.  In larger facilities I felt like a cog in a wheel, relegated to fast track to move bodies in and out as fast as possible and I knew my skill set was much broader than that. I'm now back in a smaller ER and I'm currently looking for prn work at another rural ED.  I am contracted to work 9 days a month; I have the flexibility to take more shifts..or not. This gives me great freedom but ensures that I make the salary I want.  My docs are great and we all work together as a team.  I consult with them on patients as needed, and they often ask my opinion about how to proceed with patients. There is a lot of mutual respect.

So I share all of that to say finding your place in medicine is just as important as your title.  You can be a great physician and be miserable if you haven't rooted yourself in the right place.  The same goes with PAs; it is important that we choose our specialties and our work environments very, very carefully.  As a ED PA I'm able to carve out the life I want.  The ED lends itself very well to those of us who wear many hats outside of medicine.  There are months when I feel like working a bit more, and there are other months (pre-pandemic) where I'm globetrotting for three out of the four weeks.  My best advice: live your life by design as much as you can.  Decide now what is most important to you, make a plan, work the plan, and keep working the plan until you've achieved the intended goal.  Don't chase money or titles; money is a tool to buy you necessities and experiences, and as a PA you will always have the means to make decent money.  Chase happiness, comfort, contentment.  Put your focus there and I think it will be easier for you to make the right decision.  

 

 

I agree with all of this, especially the underlined and bolded above. Been there, done that. Fast track sucks. Never again. I did more as a paramedic than as a fast track PA.. Moving the meat is not satisfying in any way. Knowing you could be replaced at a minutes notice by a new grad sucks. 

This may be one of the best posts I have ever seen here on the forum. 

  • Like 1
Link to post
Share on other sites

Thank you, EMEDPA! I have great respect for you, so that means more than you know.  It's forum members like you and others that make this platform so valuable.  Many of us have become PAs and have achieved success in our respective specialties because of the guidance and insight you all have provided over the years.  I'm just doing my part to pay it forward. I hope to shake your hand someday soon, sir!

  • Like 1
Link to post
Share on other sites
  • Moderator
20 minutes ago, chiaroscuro27 said:

Thank you, EMEDPA! I have great respect for you, so that means more than you know.  It's forum members like you and others that make this platform so valuable.  Many of us have become PAs and have achieved success in our respective specialties because of the guidance and insight you all have provided over the years.  I'm just doing my part to pay it forward. I hope to shake your hand someday soon, sir!

Join me in Haiti someday and we can call it even 🙂

www.globalhealthteam.org

Link to post
Share on other sites

Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.

Guest
Reply to this topic...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.

  • Similar Content

    • By patelp
      I would love to get some guidance of previous or current Canadians applying to PA schools in USA. 
      Thank you! 🙂
    • By Flcapa2020
      I am a new grad PA practicing for about 4 months. I work in occ med/urgent care. Without getting into specifics. A patient had and intraarticular finger fracture. I treated/ splinted conservatively and referred the patient stat to a hand specialist on the date of injury, who did not get seen until 2 months after her date of injury, due to WC insurance. The patient was unable to have surgery due to the timing of being seen by the surgeon. The patient will have permanent and stationary deficits and need future medical care for possible joint fusion. The patient is currently undergoing PT. Not only did I do a disservice to the patient as far as ensuring timely care, but the referral department did as well. How do I manage this going further? Obviously try to regain as close to normal function prior to the patients injury. I am learning from this experience when referring, especially with intraarticular fractures. I feel like this is my first error in patient care that has affected the patients condition and has directly impacted the patients quality of life and functionality. How should I proceed? Any recommendations? Not looking for validation nor looking for critique (no more than I am already giving myself). Need suggestions on how to proceed further in my attitude and semi guilt with this case. Thank you in advance. 
    • By Nypac21
      Hi all, 
      I'm a new grad starting out in ambulatory surgery-- I'm super excited because I love being hands on in the operating room. I was just wondering if any of the Surgical PAs could give some insights about ambulatory surgery? The site I'm going to be working at has 12 surgical subspecialities (list below). From what I gathered through the interview process, I'll be able to get experience in all of them. That being said I'm worried about being prepared and knowledgeable for cases. Anyone have any tips of how to study up, or even get more comfortable once starting? I have a little over a month before start date so any resources are welcome. Thanks in advance!
      List of subspecialities/ topics to brush up on🤯🥴: 
       
      Bariatric surgery
      Breast surgery
      Colorectal surgery
      General surgery
      Head and neck surgery
      Minimally invasive gynecologic surgery
      Neurosurgery
      Ophthalmologic surgery
      Orthopedic surgery
      Pediatric surgery
      Podiatric surgery
      Sports medicine surgery
      Urologic surgery
      Vascular surgery
    • By surgblumm
      What’s In A Spoonful?

      Robert M. Blumm, MA, PA-C Emeritus, DFAAPA


       

       
      Being a grandfather or grandmother is one of life’s most rewarding experiences. While reliving the early stages of life with our grandchildren we can enjoy their movies and get a second chance at some which we may have missed. I was recently watching Mary Poppins with my grandkids and found it delightful and uplifting. For days, I was rehashing that famous song in my head, “just a spoonful of sugar helps the medicine go down.” As a clinician, I paused with some concern as I had to ask myself: What, actually, is a spoonful?

      It is in the purview of physicians, NPs and PAs in pediatrics, family practice, internal medicine, urgent care, emergency medicine, retail health care and geriatrics to examine their patients who present with symptoms of a cold, allergy symptoms or a cough, resulting with a note recommending some form of OTC medicine. We commonly use the phrase “one or two teaspoons” and either document (or fail) to document this dosage.  Either way, the potential for creating an iatrogenic poisoning or a drug reaction is quite high. It is always important to know what medications your patient may be taking - a critical practice which should accompany every patient encounter, whether new or not. Most PAs and NPs enter healthcare with the idea of working for 30-40 years but prudent attention to malpractice prevention can never start too early. Thorough, thoughtful practice can illuminate cross-sensitivity to prescribed OTC drugs. We need to look at OTCs as carefully as we would any prescribed medication, and it is equally important to know the age and weight of your patient, as a spoonful may be too little or too much. If the patient is a pediatric patient, the parent may be confused by the description of a spoonful and give a tablespoon, a teaspoon or a pediatric feeding spoonful. Children who are taking a drug, particularly an OTC drug, have a much greater possibility of a reaction.

      For many of our senior citizens on polypharmacy, there are many potential drug-drug-interactions that will increase or decrease the effectiveness of their other medications making way for hypertension, severe hypotension or rhythm changes related to their cardiac drugs.  For a moment, consider the patient on Coumadin. This drug has restrictions on other medications, as well as foods and alcohol which can greatly affect the INR and create a life- threatening bleed in the brain or in the GI system. I was scolded by my cardiologist a few years ago for taking a class lll antiarhythmic with herbal drugs or vitamins and minerals. He made me wait an additional hour in his office, then had me step into his private room and asked me, “What is it that you don’t understand about taking NO additional supplements or herbs?” As a healthcare professional, he was shocked at my actions. These substances can interact with my prescribed drug regimen to the degree that I could have developed Torsade’s De Pontes.  He asked me if my need to take supplements - including fish oil, glucosamine and chondroitin - surpassed my need to live. His direct approach about my nonchalant attitude regarding supplements certainly got my attention!

      Being careless can lead to a poor outcome for the patient, as well as a possible lawsuit. What can the collective “we” do to prevent a patient incident that is negative or life threatening? Check for other medications, review current drugs, look at age and weight and be cautious to write an OTC medication unless aware of all of the possible reactions. Is there anything else to glean from this? Another related concern is failure to document the other medications and to cross reference all contraindications, which are frequent causes for litigation involving PAs as well as NPs and particularly in the setting of the Retail Healthcare Clinic or Urgent Care Center. The same focus should apply to Telemedicine since it has become particularly popular during the pandemic. These concerns should encourage clinicians to consider how to best protect themselves, their professional futures and their families from litigation due to negligence.

      Accuracy is the name of the game and is the mandate for all healthcare professionals but owning proper professional liability is the safest solution for potential error. It is not a coincidence that you are reading this today, but a heartfelt concern of a colleague who wishes all PAs and NPs a long and successful career. You do not want to create a life-threatening situation or worse. Our ultimate goal is to retire with professional pride and satisfaction – with NO history of careless nonchalance or, pardon the expression, “sloppiness”. Perhaps this “spoonful” of advice might help…

    • By EKGTech2021
      Good afternoon everyone. My name is Daniel. I am an EKG Technician. I've been in college earning credits towards a Registered Nursing program which I'm planning on attending this August. This program has a lot to offer especially in the fact that it is taking place at a teaching hospital. My true ambition, however, is becoming a Physician's Assistant. I have been very conflicted regarding this decision because I've read in certain articles that there are some PA programs out there which prefer applicants have an RN lisence.  While others say they do not require it. Apart from that aspect, I understand that as an RN I'll be learning valuable bedside clinical experience. But yet I think to myself, why wouldn't I spend my time doing online courses necessary to enrolling into a PA program until I earn a Bachelor's Degree in Applied Science? While working part time getting my clinical hours as an EKG Technician or a Medical Assistant which I am also certified in. I would like to know some of your expeirences as new PA students. How many of you were nursing students before you made the decision to transition into a PA program as a career? Would you recommend a prospective student become a nurse before even considering becoming a PA? Or would it be better to comfortably go to school while working part time? I am thinking about this logically. 
×
×
  • Create New...

Important Information

Welcome to the Physician Assistant Forum! This website uses cookies to ensure you get the best experience on our website. Learn More