LCSW —> Psychiatric PA

[KimmieTheSocialWorker]

I am a licensed clinical social worker and a certified drug and alcohol counselor exploring the possibility of becoming a Psychiatric Physician’s Assistant. I am nervous because 1) I’m almost 40 years old, 2) I am not very good at science, and 3) I have not been in school for over 17 years! I’m worried about how long it will take, if I will survive and pass all of my classes and required exams, and if I will get my student loans reimbursed. There is such great need for psychiatric providers and most are nurse practitioners or psychiatrists. I feel that PAs are underrepresented in the mental health field. I am very interested in becoming a Psychiatric PA by age 45, but have no idea how to accomplish this … 
“There are roughly 100,000 certified practicing PAs in the United States, with approximately 1,500 of them working in psychiatry.  Psychiatry is definitely one of the areas with the fewest PAs.” 
 “Currently, the NCCPA is urging Pas who want to join a collaborative team in psychiatric practices to obtain the Certificate of Added Qualifications (CAQ) in psychiatry, a new specialty credential that is held by about 10 percent of the certified Pas working in psychiatry.”
“The best use of PAs in psychiatric practices is for them to treat and manage the medications of patients with less-severe mental disorders, allowing physicians more time to spend on treating those with complex illnesses.”
“By using a physician ‘extender,’ psychiatrists will be able to provide more psychiatric services to their patients – benefiting the practice and, more importantly, meeting patients’ mental health care needs.

[CSCH]

Hi Kimmie! Congratulations on considering the PA profession. I think you will bring SO much to the table.

I graduated in a class that included two over-40 classmates (a high school chemistry teacher and a chef) who have gone on to be amazing PAs. It's daunting to consider "starting over" but you're coming in with so many strengths and I think being a PA is amazing and worth it.

As far as psychiatry goes, I don't personally practice in it, and I only know one PA who does. It can be a tough field to get into because the PMHNP (psychiatric mental health NP) programs are fairly strong. It may be one of the few fields where I would consider becoming an NP over a PA (blasphemous, I know). It's just hard to compete with that level of specialization. The CAQ-psychiatry seems to be a major plus for those in the field, but you have to get your first job in it and have experience in order to obtain the CAQ. There are also psychiatry residency/fellowship programs (APPAP has 6 programs listed) which can give you additional training as a PA, as well as something to put on your resume that proves your interest and expertise in mental health.

Good luck!

[UGoLong]

You’ve got a dream which, though it may not be an easy one, has been doable for others. The two obstacles you talked about are (1) going to school when you are older and (2) getting into psychiatry. I went back to school to become a PA and graduated at 60 (didn’t start take prereqs until I was 51) and a buddy of mine – a retired dentist no less! – started a PA program at about 50 and became a psychiatric PA in Colorado.

At your stage, you might be “walking around” a castle trying to find your way in and thinking about all the obstacles that could be out there for you. That is a sensible approach but, while you may see shortcomings – your science grades, the 17 years out of college, the role of NPs, etc – you also have some real strengths.

Not the least of your strengths is your experience as a LISW and perhaps through that some local contacts in the psychiatric community. Your maturity – and new-found motivation – may also help you overcome problems you once had as a younger person in school. Graduating with some gray hair may also give you some gravitas that your employer and patients might appreciate.

My advice as you “walk around the castle” is to experiment with a “door” or two. Take a dreaded science prereq in night school (especially if your area is blessed with a good local community college), find a psych PA you can shadow, etc. I found that by taking such baby steps, I got a better handle on my dream – and how to make it a reality – without making a huge commitment early in the game. And, surprisingly, I found the journey was a blast.

As an older person, there is a tendency to feel that “time is running out” and you have to go extra fast. While your time here isn’t forever, you hopefully have more time than you might think. In my case, I started PA school at 58, graduated at 60, worked full-time until I was 69, and still work part-time and teach for a PA program at 75. My dream – warts and all – opened up a totally new world for me and maybe it will for you too. There are no guarantees, but then when is there ever?

Good luck to you!

Edited July 10, 2021 by UGoLong

[CSCH]

@UGoLong Your story is so inspiring! I hope I will always keep that same level of passion for learning that you have.

[Apollo1]

1. Minimum 2 years to complete prereqs (probably longer if you continue to work while going back to school).

2. 2-2.5 years of being in school (work is virtually impossible, at least the kind where you make halfway decent money).

3. Job market is becoming more saturated as new schools (PA and NP) open up.

4. Specialty market that is dominated by NP's (no definitive reason why, they just do).

TL;DR: You're looking at somewhere in the vicinity of 45-46 years old at the earliest before you get out of school and can begin practicing. Depending on what you make now vs. what you could make in the future (depressed wages are distinctly possible) and probably taking on significant debt, I'd make a hard cost-benefit analysis before committing to the profession. If you really want to work in Psych, the nursing route may be your best option.

[moose1]

I would pursue the PMHNP route if you are certain you want to do Psych. About the same time to completion, more autonomy (no supervising physician, can own your own practice depending on the state) and MUCH better job prospects when you are done. There are plenty of community colleges offering an accelerated BSN you can complete in 18-24 months, then do a DNP program. Its more cost effective and frankly you have a LOT more options when you are done. 

 

You mention you don't feel very good at science. This can absolutely be overcome, but keep in mind that medicine IS science. Learning how to study and process the depth and volume of material is a learned skill that comes with practice, but I feel there needs to be a passion for it otherwise you will burn out. Hope this helps, good luck!

Edited July 20, 2021 by moose1

[CAAdmission]

If you are truly "not good at science" you're dead in the water. 

If it's really more like "I wasn't good at science" well, a lot can change in 17 years. 

 

[ohiovolffemtp]

I got my license as a PA at age 55.  1st career was corporate IT.  2nd (transition career) was firefighter/paramedic, though I had been a volunteer for years.  I'm now making almost double what I made in corporate IT which I left in 2007, though this is in EM.  So, some thoughts and suggestions:

• Shadow PA's in a number of fields so that you get a good feel for what life as a PA would be, because it varies tremendously by field of medicine.
• You are not too old, both UGoLong and I started much later.
• You can make up for the lost income and cost of schooling, but it will take awhile.  PA will pay way better than social work.
• Try the pre-reqs on a part-time basis at a community college.  See how you do at 1st year chem, 1st year biology.  That will tell you whether you can "do science".
• Remember that the NCCPA exists to make money from exams and re-certifications, so don't place too much stock on what they say about CAQ's - find out what prospective employers think.
• You are likely the exception to the preference for Psyche NP's because of your background.
• As a PA in psyche, you may well do a mix of management of medical conditions for mental health patients as well as managing psyche conditions - that's what one of my classmates does.

[KimmieTheSocialWorker]

Thanks, everyone, for all of your input! I’ve decided to pursue a PMHNP and get 7 prerequisites done, then complete a direct entry MSN-RN program, and then a post-masters PMHNP program … wish me luck!