PA or MD?

[devonf88]

I am having a really tough time deciding between whether to pursue a career as a PA or MD and was curious if anyone here wanted to offer any insight. Are there any PAs who wish they had gone the MD route or is there a general consensus that becoming a PA is much more fulfilling? I am in my mid-twenties and currently working in an ER while taking post-bacc courses that would fulfill pre-reqs for both PA programs and most med schools. I am single with no children so I have a great deal of flexibility in my decision making. I think that I would also really enjoy working in either pediatrics or dermatology. Thank you so much for any advice or experience anyone may offer.

[EMEDPA]

this is a frequent question here.

it really depends on your long term goals. if you want to call 100% of the shots and not have your scope of practice dictated by others go md. if you ever want to work overseas go md.

if you are ok with not always having the final say and having others second guess your calls go pa.

PAs do not have better schedules than docs. this is an urban myth.

I should have gone to medschool. I didn't figure that out until I was married with kids, a house, and responsibilities not consistent with attendance in med school

[nebero]

It is easy. Go to med school. Although I never regret becoming a PA, I always feel like I would have been happier doing what I do now as an MD.

[Dynamo24]

PAs do not have better schedules than docs. this is an urban myth.

 

Is this true with all specialties? I choose the PA route because I wanted to work (making more than minimum wage) sooner than later, have more time with my family, and not let my job dictate my life. I feel like being in CT, Neurosurgery, Cardiology, etc. would be pretty hectic as a PA..but what about like sports/ortho, ER, FP, rads, derm, etc?

[EMEDPA]

in all of the local er groups near me most PAs work 16-18 ten to 12 hr shifts/mo while the docs work 12-14 eight hr shifts.

most of the surgical PAs I know work 50-60 hr weeks and take call.

the central truth of the pa profession is this:

docs hire PAs to do the work they don't want to do at the times and places they don't want to do it so they can be home with their families.

you spend time in medschool and residency now so you can have an easier life later.

PAs work sooner due to fewer years of training but often work harder than they would have as docs.

[Contrarian]

Bears REpeating...

 

the central truth of the pa profession is this:

docs hire PAs to do the work they don't want to do at the times and places they don't want to do it so they can be home with their families.

you spend time in medschool and residency now so you can have an easier life later.

PAs work sooner due to fewer years of training but often work harder than they would have as docs.

 

So ummmm... why would a Physician spend money to hire a PA... then provide/ensure that this "lesser trained" new hire has a full time "cush-life" by having full time high paying short, convenient, guaranteed, standard hours without call... while the physician continues to NOT have these things...???

[EMEDPA]

there are some cush and/or part time pa jobs out there just as there are cush md jobs out there. but for those working full time, the pa will typically work earlier/later/longer/more weekends/more holidays

[Dynamo24]

in all of the local er groups near me most PAs work 16-18 ten to 12 hr shifts/mo while the docs work 12-14 eight hr shifts.

most of the surgical PAs I know work 50-60 hr weeks and take call.

the central truth of the pa profession is this:

docs hire PAs to do the work they don't want to do at the times and places they don't want to do it so they can be home with their families.

you spend time in medschool and residency now so you can have an easier life later.

PAs work sooner due to fewer years of training but often work harder than they would have as docs.

 

I don't think this 100% true at all. There may be some validity but if every PA specialty were like that, it would be a really crappy job just having to pick up scraps, work more than a doc, and make a whole hell of a lot less. I just don't hear that type of response from PA's that I know. It sounds like a very bad profession when you put it like that, unless you feel that it is. I don't know what to gather from your comments to be honest. Not arguing with you at all..you're living the life not me. Your response just sounds very doom and gloom. Especially from prospective PA students.

[EMEDPA]

there are some very happy PAs out there who work in family medicine, dermatology, pain clinics, and er fast tracks. they have great hrs, don't take call, etc. they are assistants.

many specialty PAs work like dogs but they also make a lot more money than their primary care colleagues. they are not assistants.

many fp jobs pay 80kish.

many er jobs(for example) pay 110-125k ish. you work harder, you make more. but working harder means less family time, it's a trade off. I am trying to work myself into positions with longer shifts so I can work fewer of them for the same pay as I got working lots of shorter shifts. it's all a balancing act.

[EMEDPA]

I don't think this 100% true at all. There may be some validity but if every PA specialty were like that, it would be a really crappy job just having to pick up scraps, work more than a doc, and make a whole hell of a lot less. I just don't hear that type of response from PA's that I know. It sounds like a very bad profession when you put it like that, unless you feel that it is. I don't know what to gather from your comments to be honest. Not arguing with you at all..you're living the life not me. Your response just sounds very doom and gloom. Especially from prospective PA students.

a typical pa job is that of a physician resident for life. you make 1/3 what a doc does but still, hard to argue with 100k for 2 yrs of grad school.

if you are young and single though my recommendation is md/do every time. I really wish I had done it. I am relatively happy now but I had 10+ yrs of crappy jobs before I worked my way up to a good one and really only in the last 5 yrs have I found positions that let me do exactly what I want, which is full scope em with intubations, critical pts, etc.

some folks are happy doing fast track 40 hrs/week on day shift for the rest of their lives. there are lots of jobs out there like that. I am not one of those people and I don't want one of those jobs.

[Dynamo24]

a typical pa job is that of a physician resident for life. you make 1/3 what a doc does but still, hard to argue with 100k for 2 yrs of grad school.

if you are young and single though my recommendation is md/do every time. I really wish I had done it. I am relatively happy now but I had 10+ yrs of crappy jobs before I worked my way up to a good one and really only in the last 5 yrs have I found positions that let me do exactly what I want, which is full scope em with intubations, critical pts, etc.

some folks are happy doing fast track 40 hrs/week on day shift for the rest of their lives. there are lots of jobs out there like that. I am not one of those people and I don't want one of those jobs.

 

That seems more reasonable. Most residents work ~60 hours a week + call + holidays + weekends + garbage vacation, etc. never cracking 50K a year. I think everyone imagines MD/DO being this amazing position, but there are A LOT of burnt out and unhappy doctors out there with the future only looking more bleak. But I agree if I were 22, single, no kids...MD all the way.

[PAorMDhopeful]

That seems more reasonable. Most residents work ~60 hours a week + call + holidays + weekends + garbage vacation, etc. never cracking 50K a year. I think everyone imagines MD/DO being this amazing position, but there are A LOT of burnt out and unhappy doctors out there with the future only looking more bleak. But I agree if I were 22, single, no kids...MD all the way.

 

I find it difficult to find a clear-cut line where it's "you're young, go to med school" or "I'm getting a little older, should probably do PA school." What about a married 25 year old with no kids who is interested in starting a family before 30? Entering medical school at 25/26 would leave you getting out at 29/30 (pre-residency), putting a huge strain on family hopes during those times. This is a brutal topic for me in particular, so I relate with your concerns, OP.

 

Is this just a job, or is it a calling? What about all of the "grass is always greener" talk from current physicians? It's difficult to hear people say "go to medical school" on this board when so many physicians tell people to stay away, especially with the direction that healthcare is taking.

[EMEDPA]

does this hypothetical 25 yr old have significant prior medical experience?

why is starting a family before 30 so important? nothing wrong with having kids at 35....I was 33 when my first was born.

keep in mind only the first and second yr of medical school are big time sinks. 3rd yr is basically 2nd yr of pa school, busy but not terrible. 4th yr is a vacation yr for electives and residency interviews.

internship is tough but unless you do surgery 2nd and 3rd yr are not too bad. I frequently put in more hrs than the 2nd and 3rd yr fp residents I work with.

a cush fp residency can be 45-55 hrs/week for the 2nd and 3rd yr.

I worked with an fp resident who had a baby every single yr of residency(yup, 3 kids in 3 yrs) and graduated on time.

for those who want medicine to be "just a job" and are happy in the assistant role PA is a good gig. if medicine is your passion and you can make med school work I encourage you to do so. many folks with a passion for medicine end up frustrated and feeling constrained as PAs.

docs who complain about medicine generally complain more about the administrative hassles than anything. PAs face those too (emr's, dealing with insurance companies and credentialing committees) so if you are in for the same hassles anyway why not complain from a position of greater influence? a position in which you are more respected, have a better schedule, scope of practice, and salary?

[True Anomaly]

does this hypothetical 25 yr old have significant prior medical experience?

why is starting a family before 30 so important? nothing wrong with having kids at 35....I was 33 when my first was born.

keep in mind only the first and second yr of medical school are big time sinks. 3rd yr is basically 2nd yr of pa school, busy but not terrible. 4th yr is a vacation yr for electives and residency interviews.

internship is tough but unless you do surgery 2nd and 3rd yr are not too bad. I frequently put in more hrs than the 2nd and 3rd yr fp residents I work with.

a cush fp residency can be 45-55 hrs/week for the 2nd and 3rd yr.

I worked with an fp resident who had a baby every single yr of residency(yup, 3 kids in 3 yrs) and graduated on time.

for those who want medicine to be "just a job" and are happy in the assistant role PA is a good gig. if medicine is your passion and you can make med school work I encourage you to do so. many folks with a passion for medicine end up frustrated and feeling constrained as PAs.

docs who complain about medicine generally complain more about the administrative hassles than anything. PAs face those too (emr's, dealing with insurance companies and credentialing committees) so if you are in for the same hassles anyway why not complain from a position of greater influence? a position in which you are more respected, have a better schedule, scope of practice, and salary?

 

I just wanted to highlight this bottom line, because it's not something that's really been mentioned on this forum before (or at least, that I've seen- forgive me E if you've said it before). From purely a "practicing medicine" standpoint, as a physician you are independent, period. The hassles faced in medicine, as E pointed out, are experienced by EVERYBODY- and if ANYONE has an easier time dealing with it, it's physicians. Just ask PA practice owners on this forum how they are constantly hamstrung by legal inconsistencies such as ordering PT for patients who need it, where they can freely give out narcotics as they see fit.

[Cleverisallxx]

I find it difficult to find a clear-cut line where it's "you're young, go to med school" or "I'm getting a little older, should probably do PA school." What about a married 25 year old with no kids who is interested in starting a family before 30? Entering medical school at 25/26 would leave you getting out at 29/30 (pre-residency), putting a huge strain on family hopes during those times. This is a brutal topic for me in particular, so I relate with your concerns, OP.

 

Is this just a job, or is it a calling? What about all of the "grass is always greener" talk from current physicians? It's difficult to hear people say "go to medical school" on this board when so many physicians tell people to stay away, especially with the direction that healthcare is taking.

 

I think I definitely agree with the "grass is always greener" sentiment. I'm also a married 25 year old with no kids that went through the same debate, albeit for only a short amount of time. Ultimately I realized the majority of docs I've come into contact with are burnt out or getting patients out of the office to see the next one... there are always exceptions, but I didn't want to take the chance. When I was a young teen, my mom took me to a FP doctor for "depression" and "rebellious" behavior...>.> the doctor took me to his office, turned off the lights, and explained to me this was how the world looks when you're depressed. Then he went on to complain about how I have no idea what its liked to be stressed out, and that he was working 60 hours a week at this clinic making minimal pay when he could be working somewhere else making way more for the time that he spent here... This was of course an isolated experience, and I've met plenty of happy docs but the whacky experience definitely stuck in my head.

 

OP, As EMEDPA pointed out, "some folks are happy doing fast track 40 hrs/week on day shift for the rest of their lives" and I don't know if its a bad thing or not, but I'd be okay with that. At the end of the day, I'm fine with practicing medicine and not being the boss; that's what you have to decide and be honest with yourself about. Hopefully my sentiments don't change too much once I start working, but really that's a risk you take with any career - as long as you're honest with yourself in the beginning, you'll be on the right track!

[Dynamo24]

I find it difficult to find a clear-cut line where it's "you're young, go to med school" or "I'm getting a little older, should probably do PA school." What about a married 25 year old with no kids who is interested in starting a family before 30? Entering medical school at 25/26 would leave you getting out at 29/30 (pre-residency), putting a huge strain on family hopes during those times. This is a brutal topic for me in particular, so I relate with your concerns, OP.

 

Is this just a job, or is it a calling? What about all of the "grass is always greener" talk from current physicians? It's difficult to hear people say "go to medical school" on this board when so many physicians tell people to stay away, especially with the direction that healthcare is taking.

 

Like I've said before, I'm 29 going on 30 soon, just had a baby in December. I was studying for the MCAT and realized that I was unhappy spending so much time away from my new born baby and wife. I would rather have a shorter grad school experience, have a job where I can support my family while still enjoying what I do and practice medicine...all while my doc friends are finishing 4th year or starting residency. More or less, money, title, and decision making took the back seat to my family. Much of that stems from not having a dad growing up, mom working all the time, being poor as s**t etc etc. So when I say "older" a lot more variables go into that equation. If we didn't have kids I would have stuck with MD. Its easy to make time for you and the wife without kids. For example, we have a set of friends where the husband just got matched...she just got pregnant. He was told he gets 5 days paternity leave and can't add vacation to that due to their on call schedule. He was angry, she was pretty hurt and upset about it. His job decided that he can't be the husband or father he wants to be. That alone made me feel comfortable with my decision.

[rev ronin]

For example, we have a set of friends where the husband just got matched...she just got pregnant. He was told he gets 5 days paternity leave and can't add vacation to that due to their on call schedule. He was angry, she was pretty hurt and upset about it. His job decided that he can't be the husband or father he wants to be. That alone made me feel comfortable with my decision.

 

What makes you think life as a PA will be any different? There's no guarantee you'll get the time off you want there, either.

[rev ronin]

For example, we have a set of friends where the husband just got matched...she just got pregnant. He was told he gets 5 days paternity leave and can't add vacation to that due to their on call schedule. He was angry, she was pretty hurt and upset about it. His job decided that he can't be the husband or father he wants to be. That alone made me feel comfortable with my decision.

 

What makes you think life as a PA will be any different? There's no guarantee you'll get the time off you want there, either.

[EMEDPA]

What makes you think life as a PA will be any different? There's no guarantee you'll get the time off you want there, either.

very true. one of my parters had a child last yr. he got 5 days off by asking the rest of us to cover his shifts. his formal request for time off from the group was refused.

[EMEDPA]

What makes you think life as a PA will be any different? There's no guarantee you'll get the time off you want there, either.

very true. one of my parters had a child last yr. he got 5 days off by asking the rest of us to cover his shifts. his formal request for time off from the group was refused.

[Dynamo24]

What makes you think life as a PA will be any different? There's no guarantee you'll get the time off you want there, either.

 

Well isn't that part of negotiating a contract vs. begging for a position to be matched at? Isn't that kind of your fault if you don't take that into consideration when trying to find a job? I'm not saying that all PA jobs guarantee you time off whenever you need it, but for circumstances like that most jobs try to accommodate a little better than 5 days.

[Dynamo24]

What makes you think life as a PA will be any different? There's no guarantee you'll get the time off you want there, either.

 

Well isn't that part of negotiating a contract vs. begging for a position to be matched at? Isn't that kind of your fault if you don't take that into consideration when trying to find a job? I'm not saying that all PA jobs guarantee you time off whenever you need it, but for circumstances like that most jobs try to accommodate a little better than 5 days.

[Dynamo24]

very true. one of my parters had a child last yr. he got 5 days off by asking the rest of us to cover his shifts. his formal request for time off from the group was refused.

 

Man that is rough business. Did he ask for an abnormal amount of time or something?

[Dynamo24]

very true. one of my parters had a child last yr. he got 5 days off by asking the rest of us to cover his shifts. his formal request for time off from the group was refused.

 

Man that is rough business. Did he ask for an abnormal amount of time or something?

[EMEDPA]

Man that is rough business. Did he ask for an abnormal amount of time or something?

he asked for 1 week. denied. we had several folks out on sick leave at the time and so he couldn't take time off. it's an older group and there is almost always someone out for extended sick leave or a long vacation approved months in advvance.