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Why doesn't everyone do PA then MD?


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It may well be that I don't grasp the full depth of a doctor's science background and training, but I'm wondering... Since all doctors are trained in general medicine first before they specialize, why not just divide medical school into two parts? Part One, two or three years, and you become a generalist PA. Work for a bit, or not, then do Part Two, two more years, where you specialize in Family Medicine, Cardiology, or whatever, and then do a residency. Then you're an MD.

 

Makes sense to me. What am I missing?

Thanks for your response, Oneal. I've heard that there is one medical school that will give one year's credit to PAs, shortening the medical school time from four years to three years. Maybe this is the start of a trend.

So 3 years (couldn't do it in two, not reasonable for med school track) + 1-2 years of work + 2 years of school + 3-7 years of residency = 9-14 years of education (13-17 with undergrad) + what...350-400K in loans? Medical school is unattractive to a lot of people because of time + debt. Looking at those numbers seem unattractive to me especially as a non-traditional student. They probably would pay you bread crumbs for that 1-2 years of PA work because you're in the "program" still.

Only for the past 2 yr has there been any kind of "bridge", and it's 3 yr, not 2. Costs me another $150k in tuition alone on top of my $80k for PA & undergrad.

Not cost-effective at all. I don't recommend it. If you know you want to go to med school, just go.

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IMO, the PA-DO bridge at LECOM isn't really a bridge. There are some international med schools like Oceania that, i believe, they say will give you credit, but I wouldn't risk attending one if those. I don't know much about them however.

The idea of going through 4 years (or even 3! of med school) plus 4 years of residency or more after this makes me want to cry and then kick things. 2 years in PA school is plenty for me.

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The idea of going through 4 years (or even 3! of med school) plus 4 years of residency or more after this makes me want to cry and then kick things. 2 years in PA school is plenty for me.

many residencies are 3 yrs( fp, im, em, etc).

I seriously contemplated becoming an MD vs. PA. However, at my age (43), I would never recoup the investment of med school (about $250K in student loans to do so) before retirement age. PA appeals to me more because I'll still get training in med school and my work would be a collaborative effort with MDs. The cost is much less because I only have to complete my BS and then the PA, which is a Master's degree. I'll be doing what makes me tick (diagnosis, treatment, etc.) and that makes me happy :)

IMO, the PA-DO bridge at LECOM isn't really a bridge. There are some international med schools like Oceania that, i believe, they say will give you credit, but I wouldn't risk attending one if those. I don't know much about them however.

 

Yah. I read about this Oceania. Is that legit? Anyone know anyone who actually did it?

many residencies are 3 yrs( fp, im, em, etc).

 

Yes but you're forgetting about the internship year, which is worst year. So most still add up to 4. Not to mention if you take a fellowship in anything it could add 1-2 years.

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Yes but you're forgetting about the internship year, which is worst year. So most still add up to 4. Not to mention if you take a fellowship in anything it could add 1-2 years.

Um...3 year IM, FP, EM includes the intern year, which is by far the majority. I'm not sure I know of any 4 year IM or FP. Oh and anesthesia can be 3 year as well.

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Yes but you're forgetting about the internship year, which is worst year. So most still add up to 4. Not to mention if you take a fellowship in anything it could add 1-2 years.

3 yrs includes the internship. really, trust me on this one. there are a few 4 yr em programs but most folks think of the extra year as the "100,000 dollar mistake" and shoot for 3 yr programs.

3 yrs includes the internship. really, trust me on this one. there are a few 4 yr em programs but most folks think of the extra year as the "100,000 dollar mistake" and shoot for 3 yr programs.

 

Note taken. Either way...the PA+MD route that he was bringing up does not seem reasonable based on many factors. You're a medic turned PA right? I know a lot of guys that want to go that route but never even dream of talking about MD route...they would rather do just PA. Keeping the programs separate is for the best.

What I had in mind in the original post was not lengthening medical school, or forcing medical students into years of "PA internships".

 

 

The idea was breaking medical school into two parts. Complete part one and you become a PA. Stay for two more years and you would become an MD. This would leave open the possibility and a person who didn't want to commit to medical school but years later wants the MD could continue their education. Rather like getting a master's degree then getting the Ph.D. Some Ph.D. programs award a master's degree when you are halfway through with your Ph.D. program, so I think there is a precedent for this sort of thing. If you decide you don't want to go all the way, you can leave midway with a master's degree. (and practice as a PA).

 

 

I could be wrong, but I would think doctors might like this idea. They could get some hands on patient care and clinical rotations in as a PA before they have to dedicate themselves to a specialty. Doctors would understand the capabilities of a PA because it would be the same as their first two years of med school before they specialized.

Your idea is basically what some refer to as the "stem cell model". I like it as a means of totally overhauling medical education which is largely wasteful and redundant. I propose that the first 2 yr would be very much the same as M1-2 now and PA didactics would be lengthened accordingly. Then M3 would proceed the same as it does for both PA2s and M3s. If you want to get off at year 3, you take PANCE, pass and become a PA-C. If later you decide you want to return to med school, you can hop back on the bus somewhat seamlessly and after some period of study take step 2 (the M4s will have taken step 2 by now). We know that residency makes the physician.

The problem is I cannot see a way to utilize the stem cell idea without overtraining PAs and lengthening their training to 3 years post-undergrad. Also we have the issue of step 1 which M2s must take at the end of the second year--and if someone doesn't know yet whether they want to be a PA or MD/DO then we face extra (redundant) licensing exams.

Interesting concept but I am too tired to make sense of it tonight :)

The idea of being an experienced PA then taking USMLE does not sound appealing to me...quite honestly it really doesn't sound reasonable either. If you tank your USMLE, then you get to fight through the garbage residencies you don't want to go to and be treated like a peon for two years when you could mop the floor with your peers. I think the programs being separate is better in the long run. I have heard some people compare a MD/PA relationship to an EMT-P/EMT-B relationship. I laughed...and laughed. Then laughed some more. Its just not true, that is some major insecurity talking. But my main question is..why do a "stem cell" type program? Because of reasons like insecurity, med school being "harder" than PA school, more money? If people switched from PA to MD for those reasons...then I don't know what to tell you..you're shallow? Confused? I made the jump from pre-med to pre-PA because its a better fit for me, my family, and our long term well being. Plus I still get to do what I dream of doing: practicing medicine at a high level and being damn good at it.

I could be wrong, but I would think doctors might like this idea. They could get some hands on patient care and clinical rotations in as a PA before they have to dedicate themselves to a specialty. Doctors would understand the capabilities of a PA because it would be the same as their first two years of med school before they specialized.

 

But just doing your rotations in med school (which is two full years) gives you a pretty good idea of where you want to go. Trust me they aren't a cake walk either. Also, its not often you hear doctors being out of touch with PAs. They do ease their work load, increase their knowledge, and make them more $$. Doctors expect PAs to know almost everything they do, so they fully understand their capabilities. Not to harp on you but these factors just don't seem reasonable. While it would be nice for an increased PA role w/ better compensation, it doesn't seem justifiable to create a program like this. I think expanding PA residencies as an option is a fantastic idea. This would increase early PA compensation and give physicians an easier time hiring PAs into their groups. Its just not as wide spread as it should be.

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Note taken. Either way...the PA+MD route that he was bringing up does not seem reasonable based on many factors. You're a medic turned PA right? I know a lot of guys that want to go that route but never even dream of talking about MD route...they would rather do just PA. Keeping the programs separate is for the best.

 

No, RN.

 

I disagree.

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