What is really right for me: PA school or Med school?

[LydiaRomo]

Here's a quick summary. I am looking for genuine thoughts on this, although I know there may be some bias due to this being a PA forum. 

That said, I just turned 27 years old (female), just got married, and currently work as a clinical research coordinator (7 or 8 months now, with very little HCE/PCE but my manager is working with me to ensure that I can get as many hours interacting with pts as possible.) 

My history is a rough one. Bad childhood, bad teenage years, almost did not graduate high school but pulled thru with like a 2.8 or something. Decent enough ACT score to get into a state college, but due to many (home) issues, mental illness, etc I dropped out multiple times and fucked up my GPA with zeros, then lost my scholarship. Of course, this was back in 2016-2018, so a while ago. After that, I began working in sales and tech, eventually finding my way to med device and realizing I really, really want to be a part of medicine. 

I quit my high-paying job to become a very junior study coordinator with bad pay but good benefits in order to set myself up for PA school. I am enrolled in a Biology program online via ASU and plan to take pre-reqs at the school I work at (Northwestern University). I have roughly 3 years left and I have a good GPA.

Here's what I want out of medicine:

1. I want a face-paced job. I thrive in chaos and disorder and naturally tend towards leading. 

2. I want autonomy, but I don't need total autonomy to be happy, at all. Just enough to feel like I am able to do my job mostly on my own.

3. I want to genuinely understand the human body. It's fascinating, and extremely important to me to achieve this. 

4. Procedure-heavy work. I absolutely want to work in a hospital only, regardless of PA/MD/DO. I want to be in on the action. I would like to have these skills to take to disadvantaged areas and volunteer my time or take deployments with NGOs etc to help people. 

Here is why I am conflicted: 

1. If I were even just 3 years younger, I would be aiming for med school. PA school is something that felt like the closest a person like me could get to medicine, so it felt like the obvious choice. But I am 27, married, and want to have my first baby in a couple years.

2. I have heard horror stories and I don't want med school/residency to kill my marriage or make me miss literally every aspect of my child's life. My husband is very strong, extremely supportive, and more than capable and willing to step up to help me achieve anything I desire. I also am willing to sacrifice some time with my future children to pursue this- I just don't want to be a totally absent mother for the first few years. 

3. Pay in residency. Money is not my main driving force, but an additional 3 or so years (depending on the specialty, leaning towards EM) earning small wages and working long hours might be horrible, but then post-grad, I would be making much more money as an MD than as a PA. Eventually, up to 3x as much. However, as a PA, I would be earning six figures right after graduation. 

4. My past is horrible and I feel so much shame around it. I am horrible at math, I missed most days of school, I even went to rehab in my junior year of HS and fell behind. I spent years addicted to Xanax, and I used to have the executive function skills of a peanut. I am much better now, but how much MORE would this hold me back from MD programs vs PA? Or even both?

I really hope someone reads this long rambling post and has some thoughts they can share with me. It would be much appreciated, 

Thank you,

[SedRate]

I haven't gone to med school but it is a longer path than PA. They are both drinking from a fire hose and require that you can do well scholastically. PA school can also damage relationships. I've known people who've had children and gotten married in both med school and PA school. I've also known PAs who devote their time to their career (especially the first few years in practice) and miss the first years of their kids' lives. I was one of them (minus the kids).

As for thriving in the chaos, yes, there can be a component of that when a patient is crashing or when I'm trying to manage multiple patients at one time. There are varying levels within the various specialties. Medicine also includes a different kind of chaos like trying to meet metrics made by non-medical people (and not really the fun kind in sales), making hurting and angry patients and/or family members happy, spending lots of time on the computer, interacting with sometimes-less-than-kind consultant docs/PAs/nurses at inopportune times, etc.

Your best course is to shadow and talk to many. Twenty-seven is still a very young age so med school is very much still an option. I think it comes down to what you want, can you get there, and whether you keep your head on straight throughout the journey. Addiction and abuse in all forms can very much and does happen to PAs and docs. 

[68WEMTto65DPAC]

The practicals are important (age, marriage, kids, pay, etc.), but out of all those the first thing you have to decide is what type of work you want to do and how supportive is your spouse/family of either path.

Type of work: when you say you want a procedure-heavy practice, how much are we talking? Surgery? There are a handful of specialties in which PAs do a lot of procedures (CT surgery, Ortho, Derm, for example), but even then they don't do nearly as many or as complex procedures compared to their surgeon counterparts. If being in the OR watching the surgeon operate is going to make you jealous and hate your job, PA might not be for you. The best thing for you to do is find PAs in surgical or procedure-heavy specialties and shadow them. You will get to see the procedures they do, talk to them about how often they do that type of work, and you will inevitably see surgeons in the OR which you can watch what they do.

Support: age isn't really an issue, support is. PA school is the most practical choice out of the two for obvious reasons, namely, length of training. However, a strong argument can be made that it is harder to get into PA school than medical school (idk there's any data to support this, but the typical PA program has a class size of 20s-50s which is much smaller that your typical med school class size in the 80s-100s. This alone makes getting into PA school incredibly competitive). So, some people spend 2-3+ years applying to PA schools and at that point they could've been almost done with medical school had they been accepted to one (obviously getting into medical school is very competitive as well so there's no telling that someone would've gotten in unless they apply to both PA and medical schools).

Now, PA school is hard to get into, and harder to get through. But that's where the road ends. Once you're done with school, you're done and off to work. With medical school you would still need to worry about residency, matching, working incredibly long hours at a low salary, research, the endless "need-to-impress" lifestyle, all of which can cause a great deal of stress on the family. The first few years of PA practice are stressful, but I would say it's a lot more manageable than residency/fellowship/etc.

Shadow, shadow, shadow...and DON'T settle. If MD/DO is what you end up preferring, plan for it, and use this time to prepare your family for it. Either way it'll be a long, hard journey. You might as well get what you want for all the effort you're going to have to put into it.

Also, easier said than done, but time to forgive yourself from the mistakes of the past.

Edited December 14, 2023 by 68Whereisthewhiskey