How do I decide between PA or MD/DO?

[dancinggirl2016]

I'm currently a sophomore in college and have been planning to go to PA school. However, I've recently become really indecisive about going to med school or PA school. They both have their pros and cons. I just wanted some perspective about whether my pros and cons were true and justified and what your thoughts were on why you chose PA or didn't choose PA.

Pros of Medical School:
*Ultimately a higher pay.
*More school = better healthcare provider.
*I like learning and would love to learn everything I could about medicine.
*Higher level of respect.

Cons of Medical School:
*Expensive - the idea of being 250k+ in debt honestly makes me want to throw up.
*As much as I love learning, the idea of not truly being out of school until my 30s (due to residency) feels like a major sacrifice.
*I want to have a family (and actually be able to see them). I don't want to be on call every other weekend.
*I would like to work less than 50 hours a week.

Pros of PA School:
*Cheaper
*Less time - would still get part of my 20s outside of school.
*Can switch specialties (this is a huge one). I know it's not always as easy as sometimes portrayed, but it is possible.
*Ability to consult with physician if needed.
*Easier to find jobs with no call and a normal 9-5 schedule M-F.

Cons of PA School:
*Less education
*Being handed all of the cases that the doctor doesn't want (not sure if this is true or not?)
*Glass ceiling??

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[Cryc_to_the_point]

For me it was simply that PA's don't function in the way that I want to practice medicine. Simply, they aren't in the positions that I want to occupy so I went DO. If they do what you want to do, by all means be a PA and if not, well then do medical school.

 

[dancinggirl2016]

For me it was simply that PA's don't function in the way that I want to practice medicine. Simply, they aren't in the positions that I want to occupy so I went DO. If they do what you want to do, by all means be a PA and if not, well then do medical school.

What's the difference between what they do on a daily basis? The PAs that I've shadowed didn't even have doctors working in the same area as them and clearly had a high level of autonomy. It seemed like they were doing the exact same things that a physician would do. But, that's hard to judge when you're not the one actually in that position.

 

[DoubleBogey]

I'm currently a sophomore in college and have been planning to go to PA school. However, I've recently become really indecisive about going to med school or PA school. They both have their pros and cons. I just wanted some perspective about whether my pros and cons were true and justified and what your thoughts were on why you chose PA or didn't choose PA.

Pros of Medical School:
*Ultimately a higher pay.
*More school = better healthcare provider.
*I like learning and would love to learn everything I could about medicine.
*Higher level of respect.

Cons of Medical School:
*Expensive - the idea of being 250k+ in debt honestly makes me want to throw up.
*As much as I love learning, the idea of not truly being out of school until my 30s (due to residency) feels like a major sacrifice.
*I want to have a family (and actually be able to see them). I don't want to be on call every other weekend.
*I would like to work less than 50 hours a week.

Pros of PA School:
*Cheaper
*Less time - would still get part of my 20s outside of school.
*Can switch specialties (this is a huge one). I know it's not always as easy as sometimes portrayed, but it is possible.
*Ability to consult with physician if needed.
*Easier to find jobs with no call and a normal 9-5 schedule M-F.

Cons of PA School:
*Less education
*Being handed all of the cases that the doctor doesn't want (not sure if this is true or not?)
*Glass ceiling??

Respect nowadays is lacking for the MD/DO

Many many different fields (surg - gen surg, ENT, trauma surg vs Cards/GI/Hospitalist/PCP/HemeOnc/Nephro etc) call structures (triage service/doing daytime admits, week long 24hr etc) and groups (hospital employed/private) provide a wide variety of demands/responsibilities. So, if “family friendly life” is a deterrent for MD/DO - I would say that’s not accurate (I work with multiple people doing 8-4 hours 4d/wk with no call - pay isn’t what it could be, but better than PA).

I have a family member who is a PA and works 1wk a month- part time and keeps their skills sharp. Haven’t heard of this in the MD/DO world, probably could find it but not as common with PA

As a practicing MD with multiple family members in both PA and MD/DO communities, your pay will be capped with PA route. Tough to break above 130-150k range for PA (and that’s above 90th percentile, and not very common to see, but I do know of PAs pulling that in, avg is around 90k). For MD/DO, you can certainly pull more (different fields certainly greater potential) but making mid 250s is base/minimal bonus to achieve.

While some PAs function very much like an attending, especially those more seasoned - the attending of record is ultimately responsible. Not always a joy to be ultimately responsible for good/bad outcomes. However, if I’m stuck on something or a case is transitioning outside the score of my practice/comfort level, I can curbside or consult to bounce ideas of someone else.

I see some PAs get riled up when they are “doing what an attending would do” for 1/5 of the pay. Others love the field, enjoy their scope of practice and think med school as a suckers choice.

 

[Cryc_to_the_point]

What's the difference between what they do on a daily basis? The PAs that I've shadowed didn't even have doctors working in the same area as them and clearly had a high level of autonomy. It seemed like they were doing the exact same things that a physician would do. But, that's hard to judge when you're not the one actually in that position.

Whether you saw them or not those PA's are working under the authority of a physician. PA's generally aren't able to take the lead in high acuity patients in areas of Surgery, CCM, or EM (one of the areas I'm interested in). They do however, participate heavily with a focus on the less ill patients. Additionally, they cannot be medical directors and generally are just less prepared for the sicker patient population and the treatment of those persons.

 

[pamac]

With female physicians that I’ve seen around me and that treat my family, I’ve noted that there does seem to be the shadow of their work commitments hanging over their family lives, especially with small kids. My spouse and I go in for well baby checks together, and I wonder what the doc misses out on by being there taking care of my babies while someone is watching hers. I know for a fact that it takes a toll. The problem with the lucrative specialties and situations in medicine is that they seem to be guys that require time commitment. The ones with more flexibility seem to be less lucrative overall. And the debt issue has a lot to do with keeping some of the moms wanting family time from getting it. I don’t think my kids doc is in it for money, I think she’s plugging away because there’s debt to pay, and her commitment to her employer and patients, as well as the fact that she went through a great deal of effort to get where she is that she doesn’t want to waste that opportunity. I’m not just guessing at that assessment, as she’s spoken with some folks I know about it. I’m grateful for her sacrifice, but I acknowledge the fact that it really is a sacrifice for her. It’s more than I wanted to give up.

 

[dancinggirl2016]

With female physicians that I’ve seen around me and that treat my family, I’ve noted that there does seem to be the shadow of their work commitments hanging over their family lives, especially with small kids. My spouse and I go in for well baby checks together, and I wonder what the doc misses out on by being there taking care of my babies while someone is watching hers. I know for a fact that it takes a toll. The problem with the lucrative specialties and situations in medicine is that they seem to be guys that require time commitment. The ones with more flexibility seem to be less lucrative overall. And the debt issue has a lot to do with keeping some of the moms wanting family time from getting it. I don’t think my kids doc is in it for money, I think she’s plugging away because there’s debt to pay, and her commitment to her employer and patients, as well as the fact that she went through a great deal of effort to get where she is that she doesn’t want to waste that opportunity. I’m not just guessing at that assessment, as she’s spoken with some folks I know about it. I’m grateful for her sacrifice, but I acknowledge the fact that it really is a sacrifice for her. It’s more than I wanted to give up.

Are you a PA then? If so, do you have a good work/life balance?

 

[dancinggirl2016]

While some PAs function very much like an attending, especially those more seasoned - the attending of record is ultimately responsible. Not always a joy to be ultimately responsible for good/bad outcomes. However, if I’m stuck on something or a case is transitioning outside the score of my practice/comfort level, I can curbside or consult to bounce ideas of someone else.

I see some PAs get riled up when they are “doing what an attending would do” for 1/5 of the pay. Others love the field, enjoy their scope of practice and think med school as a suckers choice.

One of the things that I think is appealing about PA is that they don't have to be the boss and aren't always as responsible as a physician would be. But, a physician would also (if just basing off of schooling/training) be better equipped to make a more accurate diagnosis (this is of course somewhat of a generalization). This ideally means that they are less likely to make a mistake.

If you had to go back would you choose medical school, PA school, or something else entirely? Why?

 

[DoubleBogey]

One of the things that I think is appealing about PA is that they don't have to be the boss and aren't always as responsible as a physician would be. But, a physician would also (if just basing off of schooling/training) be better equipped to make a more accurate diagnosis (this is of course somewhat of a generalization). This ideally means that they are less likely to make a mistake.

If you had to go back would you choose medical school, PA school, or something else entirely? Why?

Occasionally there’s a day where it would be nice to call up the attending and say “hey this guy’s/family is being really challenging/difficult” and just dump/turf it etc.

If I did things again, probably do business school and become a trader - ever make 42k in 8hrs? Stressful, but great independence and earning potential is limitless. Most traders lose money - probably 80% or so.

Don’t get me wrong though; treating patients and being trained in a trade in high demand is great. Liability can drain on you.

Regardless, my personal take and observations on why people choose PA vs MD/DO are (not limited to):
- wanting a family (PA is much more family friendly)
- flexibility with jobs (PA allows change in speciality throughout career)
- income potential (MD/DO)
- autonomy (MD/DO)

Both are in high demand, flexible with work schedule and provide good job security. Generally (and don’t take this as insult/insensitive), women who want a family enjoy the flexibility of being a PA - also entering early into workforce leading to starting a family sooner - tough to have kids during med school and/or residency, can be done but tough.

Most PAs I know, apart from being in critical care units, typically will “run the list” at the end of the day (inpt) and most of the time don’t need to run things by the attending.

 

[ilovepita]

I shadowed a bunch of derm PAs and now I work as a medical assistant and they love their lives. Really made me realize you can love medicine without being a doctor and there's nothing wrong with being a mid-level provider

Being a doctor was too big of a commitment in terms of time and money but I still wanted to practice medicine. I've also met PAs and NPs who have their own clinics so being a mid-level provider seemed the best fit for me.

I never really came to medicine for the prestige or status. I just want to be able to practice it in some way shape or form and being a PA helps me do that.