When asked why not PA, how did you answer?

[LadyWolverine]

I just don't want to hear how you rejected my path and what a smart decision it was. I don't care.

Yet this is what I hear, constantly. Now that I've started rotations, I hear it at least once a day, sometimes more (it depends on the company and site where I am working). I would never go around telling the NPs that "I could have gone to NP school, but I didn't because med school is better," or the PAs that "I know more than them because med school is better than PA school." As a matter of fact, I don't even bring up my educational background unless asked, and even then, I am reluctant to talk about it. So why is the reverse completely acceptable?

I'm just here to do my job and learn what it is that I need to learn to be a competent physician. I'm not here to put anyone else down, step on anybody else's toes, or block anybody from pursuing their career of choice. Every person has his or her own reasons for doing what they do. But, as I've said before, if becoming a doctor and doing a physician's work is important to you, go to medical school. If medical school is too long/expensive/difficult/time-consuming/whatever other excuse exists, there are plenty other careers out there that will allow you to help take care of patients. But don't have a complex about your choice! The bottom line is that you can't be a doctor unless you do all of the work that it takes to get there. There are very important reasons why these standards are in place!!

---

Members don't see this ad.

 

[PreMedPrincess]

Well, we'll disagree here. I'm certainly all for being open to input from various sources, but I still don't agree with the assertion that a PA and an MD are somehow equal in medical skill and knowledge, reducing the difference to nothing more than different initials behind one's name (which is how I read his assertion, but I'm perhaps wrong).

As for the politeness, I'm certainly cognisant of that and I try to be reasonably civil in my own discussions. I must agree with LadyWolverine, however, in that there does seem to be a tiresomely pervasive desire for people pursuing a mid-level certification to validate their decision with people pursuing/holding an MD, which smacks strongly of a strange (and entirely unjustified) inferiority complex. Just as I noted above in the Community College vs. Four-Year University situation, I totally understand that many people can find a valuable role by taking a less demanding and shorter path; I just don't want to hear how you rejected my path and what a smart decision it was. I don't care.

Well, i'll have to disagree with you there. MD/PA and CC/4-year are not analgous. A CC is designed for students to transfer to a 4-year to obtain a BA/BS degree, thus making classes between the two mostly transferable. This is not the case when comparing the MD/PA complex. MDs, as mentioned, go through 4 yrs medschool and 4 yrs residency, which the PAs do not. Coursework is not transferable between PA/MD, nor is the residency. As well it shouldn't be.

Inferiority/Superiority are reflection of individual insecurities. Furthermore, PAs and physicians are NOT colleagues as was mentioned by Sunfire. You are the Physician's assistant. Not his/her collegue. Thought I would clarify since you are so detail oriented, Sunfire. In fact, I would make the comparison that a PA is to a Doctor what an administrative assistant is to a CPA(or insert any other proffession).

 

[LadyWolverine]

Coursework is not transferable between PA/MD

Then why all this talk of PA and MD students taking the same courses/covering the same material/having the same professors?

 

[deleted6669]

"Furthermore, PAs and physicians are NOT colleagues as was mentioned by Sunfire. You are the Physician's assistant. Not his/her collegue. Thought I would clarify since you are so detail oriented, Sunfire. In fact, I would make the comparison that a PA is to a Doctor what an administrative assistant is to a CPA(or insert any other proffession)."


If you are going to be insulting at least get the title straight:
physician assistant, no 's. we don't belong to the physician.
and yes, we are colleagues. you will see that when you get into a clinical situation someday.

col·league [ kó lg ] (plural col·leagues)
noun
Definition:
fellow worker: a person somebody works with, especially in a professional or skilled job
[Early 16th century. Via French< Latin collega "person somebody commissions with" < legare "commission, entrust" < lex "law"]

 

[Sunfire]

Yes, DeAlighieri, you are most definitely wrong. You are so wrong that it comes across as if you haven't read a thing that's been said. A word of wisdom for you, this is not a healthy habit to cultivate, it's lazy and it's discrediting. If you care to discuss something that I actually did say, I'll be all for it. Otherwise, please refrain from simply using me as a platform for your own thoughts and comments.

edited to add:

I think you may have been going off of this statement that Panda Bear focused on,

Training of a "lower level" would mean next to nothing when considering someone who had been time-trained in the direct rigors of a specialty, certainly including the ED.

Aye, I said that, and I stand by it...but please when you read that statement, be sure to read it in the context of the supporting paragraph.

 

[PreMedPrincess]

Then why all this talk of PA and MD students taking the same courses/covering the same material/having the same professors?

3x you got me? They do? Oh to hell with it...im going to PA school.

 

[PreMedPrincess]

"Furthermore, PAs and physicians are NOT colleagues as was mentioned by Sunfire. You are the Physician's assistant. Not his/her collegue. Thought I would clarify since you are so detail oriented, Sunfire. In fact, I would make the comparison that a PA is to a Doctor what an administrative assistant is to a CPA(or insert any other proffession)."


If you are going to be insulting at least get the title straight:
physician assistant, no 's. we don't belong to the physician.
and yes, we are colleagues. you will see that when you get into a clinical situation someday.

col·league [ kó l&#63485;g ] (plural col·leagues)
noun
Definition:
fellow worker: a person somebody works with, especially in a professional or skilled job
[Early 16th century. Via French< Latin collega "person somebody commissions with" < legare "commission, entrust" < lex "law"]

colleague

noun
1. an associate that one works with
2. a person who is member of one's class or profession; "the surgeon consulted his colleagues"; "he sent e-mail to his fellow hackers"

WordNet® 3.0, © 2006 by Princeton University.

See, i can do it too.

They are NOT colleagues. Stop lying to yourself.

 

[Sunfire]

PreMedPrincess, you're speaking to the PA who runs his ED, so you might want to close that immature, inexperienced mouth of yours and listen a little.

 

[LadyWolverine]

I look to all other medical care providers as colleages. Everyone should be treated with respect in the workplace, because we all (with a few notable exceptions) serve a function. As I said before, I just want to do my job and learn what I need to know. There's no need to puff out your chest and show off your credentials/knowledge if it's not benefiting anyone.

I wish that some of the mid-levels I have encountered in recent experience subscribed to the same philosophy. It would make work so much more pleasant. There's plenty of room (and patients) for all of us, at least where I am right now.

 

[Sunfire]

LadyWolverine, you I could work with.

 

[PreMedPrincess]

PreMedPrincess, you're speaking to the PA who runs his ED, so you might want to close that immature, inexperienced mouth of yours and listen a little.

LOL!

talk about superiority complex!

the definition of a word has nothing to do with experience. That is how Princeton defines colleague. And according to that definition, PAs and Docs are NOT colleagues.

This is what pisses me off the most: My aunt, who is a nurse, manages to say "I know doctors go their school, but there are a lot of dumb doctors and a lot smart nurses." She says this at every get together atleast once, specifically to piss off my dad, who is a cardiologist. He just smiles, but I want strangle her! lol

 

[PreMedPrincess]

I look to all other medical care providers as colleages. Everyone should be treated with respect in the workplace, because we all (with a few notable exceptions) serve a function. As I said before, I just want to do my job and learn what I need to know. There's no need to puff out your chest and show off your credentials/knowledge if it's not benefiting anyone.

I wish that some of the mid-levels I have encountered in recent experience subscribed to the same philosophy. It would make work so much more pleasant. There's plenty of room (and patients) for all of us, at least where I am right now.

LadyWolverine, be carefull with using "mid-level." It might piss the "mid-levels" off. Wait, so who are the low-levels? Are they colleagues too?

god i sound like a bitch right now.

sorry guys.

 

[Sunfire]

PreMedPrincess, profession in this case equals practicing medicine, am I right or wrong? Perhaps (and I use the word 'perhaps' loosely, as it depends on the situation, but probably is...probably a better word), not in the same capacity, but you're dealing with patients right and left. Not the nurses, not the administrative assistants, not the man who cleans the room after a MRSA (God bless his very soul). We're talking about living, breathing, prescribing, deciding colleagues. You come across as young, so I'm taking you with a large barrel of salt, but you may want to actually learn what many Physicians (the good ones) feel about the PAs they work with, before you make such extreme judgments. Otherwise, you're simply a...robot! You don't sound like a "bitch", you sound like a kid who finds disrespect titillating. As emedpa stated, you'll understand once you get there.

 

[PreMedPrincess]

PreMedPrincess, profession in this case equals practicing medicine, am I right or wrong? Perhaps (and I use the word 'perhaps' loosely, as it depends on the situation, but probably is...probably a better word), not in the same capacity, but you're dealing with patients right and left. Not the nurses, not the administrative assistants, not the man who cleans the room after a MRSA (God bless his very soul). We're talking about living, breathing, prescribing, deciding colleagues. You come across as young, so I'm taking you with a large barrel of salt, but you may want to actually learn what many Physicians (the good ones) feel about the PAs they work with, before you make such extreme judgments. Otherwise, you're simply a...robot! You don't sound like a "bitch", you sound like a kid. As emedpa stated, you'll understand once you get there.

I am young, im 20, so what? Look, really, im just pouring feul in the fire here. But that is only because you came on here with your equality tirade. Equality in terms of medical responsibility, btw. I have nothing against PAs. Some PAs from my dad's work come to dinner-parties all the time. They are very nice people. They know their respective role and my dad knows his respective role.

oh, and as for the definition of colleague: the definition given by princeton refers to class and profession. Is the class the same between a PA and a Doc? No. Are they a part of the same profession? It could be argued yes, and it could be argued no. a CPA administrative assistant has a HUGE role, however, does that make them colleageus with the CPA? I would say no.

 

[QuikClot]

Well, we'll disagree here. I'm certainly all for being open to input from various sources, but I still don't agree with the assertion that a PA and an MD are somehow equal in medical skill and knowledge, reducing the difference to nothing more than different initials behind one's name (which is how I read his assertion, but I'm perhaps wrong).

You are. That is a straw man position. He said he had observed some attendings, on some cases, asking some PAs for advice. No specifics were added as to who had more time with the patient, experience with the patient's problem, the personalities involved, etc. Where you and some others have gotten the idea he said there was little difference between them, I have no idea.

The argument against his position, as I understand it, was that this was "weak" of the attendings, and that there should be nothing, ever, that a PA would know about medicine or the patient and the attending would not and hence, never any reason to ask a PA for advice unless one was "weak." It's a laughable idea on the face of it, and from what you said, I don't think you would want to endorse it.

 

[Nasrudin]

Premedprincess. Don't be a mean girl. Take a note from this story of the coolest cat I've ever seen:

Big Asian dude. Like an overgrown teddy bear. Funny mf'er. Just without even saying anything just...funny enough to put you in a good mood when a shift is going ****ty. Moonlighting ED resident from a local knife-and-gun club coming over to our community hospital ED for some extra cash and to basically chill from the kind of stuff he was getting hammered with. Probably hadn't slept wink in while. Looked like ****. But still managing a solid funny.

In the middle of busy--for us--shift, our resident napoleanic nurse speed addict decides she's gonna lay into the new guy with her issues. Walks up to him while he's struggling to make notes in an unfamiliar system and announces she will now "give him a clinic in urology" and proceeds to lecture him in front of his "colleagues" on how he should manage this particular patient.

Dude just looked up calmly. Almost lazily, like the building could be on fire and he wouldn't mind. And let her talk. After a couple of minutes of gaggle. He just sighed and said...."OK" and went back to what he was doing.

Style man. The dude was flawless. Timing perfect. Need I say who came off looking like cracked out speed freak with a complex.

You have learn to roll with it. People like you get fragged.

 

[DeAlighieri]

Yes, DeAlighieri, you are most definitely wrong. You are so wrong that it comes across as if you haven't read a thing that's been said. A word of wisdom for you, this is not a healthy habit to cultivate, it's lazy and it's discrediting. If you care to discuss something that I actually did say, I'll be all for it. Otherwise, please refrain from simply using me as a platform for your own thoughts and comments.

You're clearly posting while irritated, so I'll let your pedantry slide. Let's look at what you said:

For example, some ED PAs work very closely with their docs, who review each chart and initial. Other PAs work in rural clinics as the sole medical provider, with a doc reviewing their cases only once a month. Still other PAs are heads of their departments, even involved in hiring processes. It's a diverse PA world out there, and more and more are there less and less 'norms' for the profession. But make no mistake...PAs often hold lives within their hands, and their work is none the less serious and mandating. They assess, they diagnose, they explain to the patient what they see, and many people depend on them not to screw up. It all depends on the experience of the clinician, and what both the supervising DO/MD and the PA feel comfortable with.

While you didn't come right out and say it, the thrust of this (as I read it) is that doctors and physician assistants are essentially interchangeable, which implies equality as the 'norms' change. Now let me be clear here, so you'll understand me: I don't give a damn about PA or doctor egos. I'm well aware that Physician Assistants can give quality care at the mid-level of skill. I'm also aware that doctors are a hell of a lot better and more rigourously trained than PA's are. What I object to is this strange skewing of reality in an attempt to create some sort of pre-school "everyone is a winner" situation. If you're a PA, great, do your damned job. If you're a doc, great, do your damned job. Just please, for the love of all that's holy, stop trying to justify your decisions to me by pretending the PA and MD training are the same thing.

 

[PreMedPrincess]

Premedprincess. Don't be a mean girl. Take a note from this story of the coolest cat I've ever seen:

Big Asian dude. Like an overgrown teddy bear. Funny mf'er. Just without even saying anything just...funny enough to put you in a good mood when a shift is going ****ty. Moonlighting ED resident from a local knife-and-gun club coming over to our community hospital ED for some extra cash and to basically chill from the kind of stuff he was getting hammered with. Probably hadn't slept wink in while. Looked like ****. But still managing a solid funny.

In the middle of busy--for us--shift, our resident napoleanic nurse speed addict decides she's gonna lay into the new guy with her issues. Walks up to him while he's struggling to make notes in an unfamiliar system and announces she will now "give him a clinic in urology" and proceeds to lecture him in front of his "colleagues" on how he should manage this particular patient.

Dude just looked up calmly. Almost lazily, like the building could be on fire and he wouldn't mind. And let her talk. After a couple of minutes of gaggle. He just sighed and said...."OK" and went back to what he was doing.

Style man. The dude was flawless. Timing perfect. Need I say who came off looking like cracked out speed freak with a complex.

You have learn to roll with it. People like you get fragged.

ha! good story.

cmon, im just having a little fun.

 

[QuikClot]

This is what pisses me off the most: My aunt, who is a nurse, manages to say "I know doctors go their school, but there are a lot of dumb doctors and a lot smart nurses." She says this at every get together atleast once, specifically to piss off my dad, who is a cardiologist. He just smiles, but I want strangle her! lol

Isn't that statement factually true? Then why should it piss anyone off? If you're a smart and skilled physician, it's not a scary idea that there are dumb people who finished medical school and smart people who never went.

Perhaps this is unfair, but I think that the only reason to worry about the doctor not automatically being considered the smartest person in the room is because one is insecure -- because you want, once you have the title, to be able to hide behind it.

The doctor isn't always the smartest person in the room. They have a job, and everyone else has a different job, and if everyone is competent, smart doesn't necessarily come into it.

Part of the doctor's job, however, is to get whatever information or resources he or she needs to determine the best way to treat the patients under their care. If that information is in the head of someone who didn't go to medical school, and the doctor doesn't seek it out for fear of seeming dumb or "weak," then smart or dumb, they aren't competent, are they?

 

[Sunfire]

PMP, I didn't mean to rant equality, that wasn't my intention. Don't you think that's too simplistic a shell to put the nut of this conversation in, or even the topic entirely? I do. I was just trying to defend the Old Doc who asked their PA for opinion. As for the colleague matter, there's a really interesting thread on the topic over on the PA forum, feel free to come check it out if and when you have time (maybe just don't post tho hehe).

Thanks to the people who took the time to listen and respond to my ramblings, I really enjoyed the conversation. And njbmd, I am so enjoying your blogs, thanks for taking the time to put them together. I feel like I should be waving with a boquet of roses lol. I done good!

 

[PreMedPrincess]

While you didn't come right out and say it, the thrust of this (as I read it) is that doctors and physician assistants are essentially interchangeable, which implies equality as the 'norms' change. Now let me be clear here, so you'll understand me: I don't give a damn about PA or doctor egos. I'm well aware that Physician Assistants can give quality care at the mid-level of skill. I'm also aware that doctors are a hell of a lot better and more rigourously trained that PA's are. What I object to is this strange skewing of reality in an attempt to create some sort of pre-school "everyone is a winner" situation. If you're a PA, great, do your damned job. If you're a doc, great, do your damned job. Just please, for the love of all that's holy, stop trying to justify your decisions to me by pretending the PA and MD training are the same thing.

OMG, i cried. That was beautiful.

 

[DeAlighieri]

You are. That is a straw man position. He said he had observed some attendings, on some cases, asking some PAs for advice. No specifics were added as to who had more time with the patient, experience with the patient's problem, the personalities involved, etc. Where you and some others have gotten the idea he said there was little difference between them, I have no idea.

The argument against his position, as I understand it, was that this was "weak" of the attendings, and that there should be nothing, ever, that a PA would know about medicine or the patient and the attending would not and hence, never any reason to ask a PA for advice unless one was "weak." It's a laughable idea on the face of it, and from what you said, I don't think you would want to endorse it.

Sure, I disagree with the "weak" idea. Taking input from appropriate sources is perfectly legitimate, as long as one doesn't use it to shore up a weak understanding. As you'll see quoted in my reply above, I don't think I created a strawman argument, but rather took issue which what I though he was implying. I'm totally open to the idea that I'm reading what he said incorrectly, but I think he went somewhat further than simply observing a physician asking for advice from a PA.

To be honest, this is all a bit of a storm in a teacup. At the end of the day, I think most of us are adult enough to respect each other's positions and skills, and to work together appropriately. I don't lay awake at night worrying about being at the top of some stack, and hopefully people don't lay awake at night fuming at the idea of being in the middle of it. The joke's on all of us: we're all at the bottom getting crapped on by the business types.

 

[QuikClot]

Sure, I disagree with the "weak" idea. Taking input from appropriate sources is perfectly legitimate, as long as one doesn't use it to shore up a weak understanding. As you'll see quoted in my reply above, I don't think I created a strawman argument, but rather took issue which what I though he was implying.

He didn't imply that a physician and a PA were equivalent in training or in knowledge. He said that certain PAs have a lot of autonomy and have to make life-or-death decisions. That's true; physicians don't have a monopoly on that. It doesn't take anything away from the physician to acknowledge that.

I think the practical point, if the OP is still listening, is that you want to be very careful in how you talk about other health professions in your interviews (or, indeed, to their faces.) If you are going to draw distinctions, make sure they are the right distinctions. Good distinction: the physician has a deeper base in the basic sciences and is better positioned to contribute to the science of medicine. Bad distinction (because it's not necessarily true): I want to be the physician because I want to make the final decisions about patient care.

He was talking about PAs and what PAs can do in their career. It doesn't take anything away from physicians. What I think (and this is only my opinion) is that the people behind the titles always matter. Physicians get a great education, for the most part, but there is a lot more that goes into solving a particular problem than your broad fund of knowledge. Physicians are not always the most knowledgable, nor do all (or most) PAs function with the high level of autonomy of some PAs in friendly EDs or in family practice. There's no need to generalize about either profession.

G'night.

 

[Sunfire]

While you didn't come right out and say it, the thrust of this (as I read it) is that doctors and physician assistants are essentially interchangeable, which implies equality as the 'norms' change. Now let me be clear here, so you'll understand me: I don't give a damn about PA or doctor egos. I'm well aware that Physician Assistants can give quality care at the mid-level of skill. I'm also aware that doctors are a hell of a lot better and more rigourously trained that PA's are. What I object to is this strange skewing of reality in an attempt to create some sort of pre-school "everyone is a winner" situation. If you're a PA, great, do your damned job. If you're a doc, great, do your damned job. Just please, for the love of all that's holy, stop trying to justify your decisions to me by pretending the PA and MD training are the same thing.

Crap, just when I thought I was out of the water. Everything I said in my words, is true. Those aren't made up cases that I pulled out of thin air in attempt to bolster one profession and degrade another, it's simply the way of things here and there. There are PAs who sign off on every case (high level of supervision), and there are other PAs who do it once a month (low level of supervision). Deductions from that be as they may, but that is the truth! Read through my other posts, and see that I repeatedly praised Physician training, explicitly. Is that clear to you, please? But I also have to acknowledge and defend the PAs who are greatly experienced and who know their sheeot.

Let me now deal with these words, which I wrote?

"But make no mistake...PAs often hold lives within their hands, and their work is none the less serious and mandating. They assess, they diagnose, they explain to the patient what they see, and many people depend on them not to screw up. It all depends on the experience of the clinician, and what both the supervising DO/MD and the PA feel comfortable with."

My main reason for writing those things was in response to the OP, who had insinuated that they believed such proclivities were somehow not part of a PAs work. In fact, they often are. I was writing in response to their words:

I like diagnosing, looking at the films, explaining to the patient what we see and if we are gonna take the non-op vs op route. No to mention being the orchestrator of the surgical intervention. Teaching, too. I don't mind the responsibility of it all.

Since they were asking what they should say in explanation, I was attempting to help them understand that such an explanation (I excluded surgical decisions, because I haven't yet come across PAs who do that, altho I imagine there might be somewhere in the medical world, and I also excluded teaching, altho there are PAs who teach) wouldn't necessarily constitute reasons not to be a PA. Whew. This is exhausting!

Thanks for teaching me "pedantry", I didn't know that one.

 

[Sunfire]

He didn't imply that a physician and a PA were equivalent in training or in knowledge. He said that certain PAs have a lot of autonomy and have to make life-or-death decisions. That's true; physicians don't have a monopoly on that. It doesn't take anything away from the physician to acknowledge that.

I think the practical point, if the OP is still listening, is that you want to be very careful in how you talk about other health professions in your interviews (or, indeed, to their faces.) If you are going to draw distinctions, make sure they are the right distinctions. Good distinction: the physician has a deeper base in the basic sciences and is better positioned to contribute to the science of medicine. Bad distinction (because it's not necessarily true): I want to be the physician because I want to make the final decisions about patient care.

He was talking about PAs and what PAs can do in their career. It doesn't take anything away from physicians. What I think (and this is only my opinion) is that the people behind the titles always matter. Physicians get a great education, for the most part, but there is a lot more that goes into solving a particular problem than your broad fund of knowledge. Physicians are not always the most knowledgeable, nor do all (or most) PAs function with the high level of autonomy of some PAs in friendly EDs or in family practice. There's no need to generalize about either profession.

Bingo!

 

[Sunfire]

*edited due to accidental repeat*

But since I'm here...did you know that there are approximately eleven different layers to the retina?? Anatomy rocks!

 

[PreMedPrincess]

Bingo!

ok this is all getting too silly.

out of curiosity though, Sunfire, how old are you?

 

[viostorm]

--------------------------------------------------------------------------------

editing my post because this whole discussion is ******ed

 

[Sunfire]

Experience writing a few scripts, doing a few procedures, and taking call for a physician by no means make a PA their equal in terms of training ... and thankfully not equal in their scope of practice either.

Interesting. I'm curious...can you tell us what scrips PAs can write for, and what procedures they can be responsible for?

 

[viostorm]

It obviously varies by state sunfire, but when you get your unrestricted medical license ... go ahead and post it.

I'm done with this thread.

 

[Sunfire]

Bah, I think this discussion has been great. I don't even know what scrips I'll be able to write for (altho I believe schedule II is now included, http://www.usdoj.gov/dea/pubs/scheduling.html), or what procedures I'll be capable of...I can't wait to find out. Best of luck in med school, viostorm, we'll be relying on you to take up what we can't deal with, so please be ready. We both obviously still have a lot to learn...just you more than I.

 

[8744]

My only real question is, seeing that most of medical training is redundant and wholly unnecessary, do you think I am qualified to moonlight as a PA? I mean, I'm only making 12 bucks an hour as a resident and as our program does not let us moonlight, maybe if I was working as a supervised PA it would be cool.

I think new fourth year medical students should be given the option of either finishing medical school and going on to residency or "opting out" and getting certified as a PA. I betcha' some people would do it if only to start making money earlier and to be done with medical training. I mean, the training is equivalent, right?

 

[DeAlighieri]

My main reason for writing those things was in response to the OP, who had insinuated that they believed such proclivities were somehow not part of a PAs work. In fact, they often are.

Fair enough. I think we understand each other now. Of course, if we suddenly all start acting friendly, we'll lose our page views. We've already had nearly 1200 views of this mess!

Quick, everyone, wave to the lurkers!

 

[Krisss17]

Short answer: I'm not looking for a really good job in healthcare. I'm looking for a mission.

I have two sisters who are PA's. Their decisions to do PA instead of med school were all about having time to raise their families and to have plenty of room to have a life outside work. Plus they were very intimidated by the length and intensity of med school. (One of these sisters got a 34 on her MCAT, with about a 3.7 in biochem. She's not wired for happiness, really, and she'll never be happy that she went PA. Not too likely she'd be happy as a doc, either.)

I do want to make a life out of my career. I don't have kids; kids would be the life career if I had some. When I was in software, I made it my life, which ended up being mostly pointless, unfortunately. But I love working crazy hours, being too involved, always thinking about work, being responsible for million dollar decisions every day, having lots of people depend on me to not screw up, and surviving by learning as fast as I can. I want to do all that, in some form, into my 80's. I would die fast as a retiree.

I ended a very close friendship last year, because the friend was continually appalled that I would invest this kind of time and money into a big fat ego trip instead of doing nursing or PA. I'll give "ego trip" a nod for some truth, but fundamentally, I have the brains and the energy and the desire and the opportunity to be a doctor, so why on earth would I choose the easier path? In the 3 years since I left software to try for medicine, I've never considered quitting for something easier. I consider myself incredibly lucky to have this chance.

Hope that helps some. Best of luck to you.

Way to go, Dr. MidLife. I, too, am in the same situation although you are further along. I'm in a nursing program now (ADN), and I plan on working while finishing my undergraduate degree and then applying to med school (LECOM-B is my first choice). While it is true that I may be near 50 when I finally graduate, I don't really care. I have good genes and hopefully if I continue along those same lines, there is no reason I can't continue for quite a while.

Best of luck at Nova!

 

[8744]

*edited due to accidental repeat*

But since I'm here...did you know that there are approximately eleven different layers to the retina?? Anatomy rocks!

Who cares? It's all just useless minutia that you really will never need to know.

 

[Sunfire]

My only real question is, seeing that most of medical training is redundant and wholly unnecessary, do you think I am qualified to moonlight as a PA? I mean, I'm only making 12 bucks an hour as a resident and as our program does not let us moonlight, maybe if I was working as a supervised PA it would be cool.

I think new fourth year medical students should be given the option of either finishing medical school and going on to residency or "opting out" and getting certified as a PA. I betcha' some people would do it if only to start making money earlier and to be done with medical training. I mean, the training is equivalent, right?

Well, no, I don't believe the training is equivalent, altho PAs are taught in the 'medical model' (whatever the hell that means). I do know that one of our instructors is both an MD and a PA, although I think that they probably were a PA before they became an MD. They do still have the PA certification tho, so I guess they still value it to some degree.

I care! Go eat your bamboo! And I get to take Anatomy twice, so nyah nyah!

 

[PreMedPrincess]

Who cares? It's all just useless minutia that you really will never need to know.

i think it was more of an attempt by Sunfire to show that he too is learning anatomy. in efforts to gain respect amongst the MDs here.

perhaps i can recite some o-chem formulas. you are going to respect me then, no?

also, 12 bucks!??!!? what yr resident are you?

hopefully you will start to work soon...because i am making 14 bucks an hr doing research.

 

[Sunfire]

Nope, I'm just still finishing up my neuro review and wanted to share what I think is really neat. Anyhow, I jumped ahead of myself, or rather I jumped ahead of the software...it appears that the retina has 10 layers, not 11, there were just two separate designations for the entire neural retina and the rods and cones segment by itself. And 10 includes the choroid and internal limiting membrane. My bad! See you on the playing field...

 

[8744]

i think it was more of an attempt by Sunfire to show that he too is learning anatomy. in efforts to gain respect amongst the MDs here.

perhaps i can recite some o-chem formulas. you are going to respect me then, no?

also, 12 bucks!??!!? what yr resident are you?

hopefully you will start to work soon...because i am making 14 bucks an hr doing research.

I am a fourth year Emergency Medicine resident with 338 day left in my residency training. I actually only work about 60 hours a week this year so my pay works out to a princely 15 bucks an hour.

 

[DeAlighieri]

I am a fourth year Emergency Medicine resident with 338 day left in my residency training. I actually only work about 60 hours a week this year so my pay works out to a princely 15 bucks an hour.

Don't worry, you'll be rubbing $100 bills on your nipples in no time. I actually had a conversation the other day with someone complaining about how much money doctors made, how they were wrong constantly, and that they should listen to the chiropractors, naturopaths, and witchdoctors more. When I explained that, broken down by hourly wage, residents were looking enviously at the kids behind the counter in McDonalds, she became somewhat less strident about you evil, Scrooge McDuck residents.

I'm still trying to explain to her that just because something is "natural" doesn't mean it a) works or b) is good for you. If it carries on, I may have to demonstrate the natural healing properties of arsenic.

 

[Perrotfish]

I mean, I'm only making 12 bucks an hour as a resident and as our program does not let us moonlight.

Is this common? I thought it was only the military residency programs that won't let you moonlight (because they pay a living wage).

 

[Empi]

LOL!

talk about superiority complex!

the definition of a word has nothing to do with experience. That is how Princeton defines colleague. And according to that definition, PAs and Docs are NOT colleagues.

This is what pisses me off the most: My aunt, who is a nurse, manages to say "I know doctors go their school, but there are a lot of dumb doctors and a lot smart nurses." She says this at every get together atleast once, specifically to piss off my dad, who is a cardiologist. He just smiles, but I want strangle her! lol

Perhaps I should keep my own mouth shut, but one huge secret to success in this world is to treat everyone in your enviornment with respect.

It will be the secretary and office manager that will make or break you. He or she could even potentially lose your applications, think about that.

Pa's and NP's deserve all the respect they get, acting all smug and superior will get you nowhere.

Even as an undergrad, our department's secretary has magical powers. She can squeeze me into classes, she can sign off documents, she can get professors on their cellphones off campus. She's the best. If I antagonized rather than befriended her, my academic life would be quite different.

 

[lastcall]

Wow, this thread is still alive and kicking. I think this particular thread must have the largest silent readership at this time..impressive for a non-trad thread. Yay for us non-trads!

 

[Tired]

There's no comparison between experience and formal education. Experience wins every day, and twice on Sunday. Nice to have both, of course.

If you think that experience as a PA is superior to formal eduction as a physician, I am baffled by your decision to pursue medicine.

Which is sadder: that Tired is so insecure he needs to believe his credentials will make him the smartest person in the room, or the fact that he was so far from being a successful medical student that he can't even imagine one that contributes to the team?

Given my specialty, I don't need to bother reciting my "successes" as a medical student. Your outcome, however, is yet to be determined. And if you really think that your attending needs your advice to treat patients, we all pretty much know how that's going to turn out.

 

[njbmd]

I told a co-worker/buddy of mine tonight that I've decided to just go on and go to medical school as I've always wanted to do. I've tried to just settle with career 'x' or the idea of careers 'y' or 'z' but I find myself saying the school plus work experience could be better spent doing what I want to do...

Having said that, he asked 'why not be a P.A.? That's what I'd do.' I've had this thrown at me a couple other times. Let me remind you, he's 31, and married with two kids, hates clinic work and the schooling. I'm just now 28 and single. While I don't fully understand the curriculum that a P.A. goes through-two years school + yr rotation/residency??-I do know that the final decisions of treatments rendered are by the physician. I really see myself doing ortho being my exposure to sports med and having worked alongside orthos over the past few years. I like diagnosing, looking at the films, explaining to the patient what we see and if we are gonna take the non-op vs op route. No to mention being the orchestrator of the surgical intervention. Teaching, too. I don't mind the responsibility of it all.

How have any of you answered why not PA or even CRNP instead of med school?

Just posting the original question as a reminder so that this thread can get back on track (or at least close to back on track). If you have a comment towards that original question or an experience to relate that can help the OP, then post it ,otherwise, try to respond to posts and information in said posts without getting into a discussion about the poster.

 

[DocM13]

The line between deciding to become a PA or an MD was a very thin one for me. I really had a hard time choosing. I guess the only reason that I decided to go for an MD degree was because that was what my dream has always been and I didn't want to have to live my life wondering, what if? all the time!

 

[southpawcannon]

Holy **** I cannot believe the number of posts and views on this thread! Last time I had a chance to look at it was the day I posted it and I believe there were roughly 9 responses at the time. I just finished playing a little catch-up on what all's been discussed since. Thanks to everyone for their philosophies on the whole PA vs MD career path. I like to learn as much as possible, apply that knowledge and be in control of a patient's care and progress.

 

[Mudfever]

I am applying to MD school this summer. My wife has been a PA for 4 yrs now. So I feel somewhat knowledgeable on this issue, as I have discussed it many times.

For me, I want to do surgery. I love working with my hands (big collector of hand tools - over 600 screw drivers ). I have shadowed and even got to scrub in on many surgeries. And with that being said, I don't want to 1st assist. I want to be the one cutting, drilling, sawing, etc. That is me, and why I chose MD over PA.

My wife was pre-med, but switched to PA to have a family life. And now with our first child on the way, she is happy with her decission. But if asked if she could go back, she says she would have done MD. I watch all the time as people say, 'Oh, you are a nurse, right?' She is used to it.

I think the problem lies in what people expect and believe. Younger, pre-PA students will approach me and say, 'Oh, your wife is a PA, she is making $120K, runs her own clinc and never works weekends.' And I say No, none of that. The majority of PA's that I know ,btw 30-40, are hired to do the things that the MD's don't want to do. Night call, weekend call, admits, consults, pre-rounding, pre-op, post-op, etc. Now, some do run their own clinics, but they still have to be supervised by a MD. Another problem lies in knowing your place. If asked her opinion by a resident or attending, she will give it. But if she believes that a physician is making a bad call, and time allows, she will let her MD know and let him confront the other physician. I believe that is one reason why PA schools love people with military training, as it is similar in that there is a ranking order.

The physician is ultimately responsible. That is the main difference. A PA may make a decision, act on it, and result in the patient dying. But it is her supervising physician's responsibility.

I believe that it all lies in what you want to do, what interests you, and your objective. That is my 2 cents.

 

[Lacheln]

I would never go around telling the NPs that "I could have gone to NP school, but I didn't because med school is better," or the PAs that "I know more than them because med school is better than PA school." As a matter of fact, I don't even bring up my educational background unless asked, and even then, I am reluctant to talk about it. So why is the reverse completely acceptable?

Because those in power (or who will be in power) don't get to bitch about those who aren't. It looks crass...you've got the power, why rub their noses in it?

Anyway, I realize this thread has degenerated into a pissing contest, but there is one critical point that I don't think has been explicitly made: doctors do, and should, seek out the opinions of their nurse and PA colleagues because they have a different, and potentially informative, perspective. They spend much more time with the patients, and therefore can notice subtleties that the doctors who are juggling more wouldn't be able to. At the end of the day that is extremely valuable, even if the ultimate responsibility lies with the doctor - as it should since they are the most highly trained.

I am going MD rather than PA because I want control, prefer the in-depth understanding, and want the various specialties open to me.

 

[deleted6669]

.

I am going MD rather than PA because I want control, prefer the in-depth understanding, and want the various specialties open to me.

what specialty can a doc work in that a pa can't?
I can't think of any....and the pa can change specialties as often as they like without having to repeat a residency...try going from plastic surgery to pediatrics as a doc...not easy.....
what specialty did you have in mind that's not on this list:
In its 2007 census report, the AAPA reported mean total income (MTI) from primary employer for clinically practicing PAs working at least 32 hours per week. ADVANCE compiled this chart using data from AAPA's individual specialty reports.

Specialty MTI
CV/CT surgery $104,363
Dermatology $103,295
Neurosurgery $95,042
Emergency medicine $94,684
Critical care medicine $92,927
Pediatric cardiology $92,611
Surgical subspecialties $92,409
Interventional radiology $91,156
Orthopedics $90,501
Anesthesiology $88,236
Trauma surgery $88,145
Plastic surgery $88,135
Surgical oncology $87,399
Urology $87,121
Occupational medicine $87,003
General surgery $86,325
Diagnostic radiology $86,297
All specialties $86,214
Pain management $86,054
Hospital medicine $84.470
Medical cardiology $83,931
Pediatric oncology $82,306
Otorhinolaryngology $82,242
Internal medicine subspec. $81,992
Medical oncology $81,956
Addiction medicine $81,927
Radiation oncology $81,703
Geriatrics $81,231
Pediatric subspecialties $81,157
General internal medicine $80,971
Psychiatry $80,967
Family medicine $80,534
Medical gastroenterology $80,051
Medical neurology $78,923
Nephrology $78,863
Allergy $77,901
General pediatrics $77,825
Rheumatology $77,134
Endocrinology $76,467
Pediatric gastroenterology $76,170
Obstetrics/gynecology $75,275
Public health $74,864
Pediatric neurology $74,509