Okay my bad. So you are saying that they don't have the right "attitude" because they want to "clock in-clock out and get paid". Im suggesting that your claim about 1/4 of your class being happier as PAs, even though they haven't said that explicitly, is debatable. I just wanted you to elaborate on why you think that 1/4 of your class would be happier as PAs. The point I wanted to make is that physicians/residents have told me that they think of their work as clock in-clock out. So, if clock in-clock out exists within medicine, why shouldn't people go the MD route vs PA?
EDIT: Also j/c if you think 1/4 of your class would have been happier as PAs then why would it have not interested you at all? I assume its because you aren't in primary care?
First, few things.
#1 There are few attending physician positions that are true "clock in, clock out". Yes, the ER is a good example of where this is true, but the vast majority of physicians still either have explicit patient duties (call) or are invested in their patient's care to the point that they still do things even when they don't have
have to.
#2 It is a bad sign if residents see their work as "clock in, clock out". You only get 3-7 years to learn how to do everything that you need to in order to practice medicine. Yes, you can learn the bare minimum for your specialty in that time, even if you aren't very good. Yes, you can get your numbers, even at the worst program. But, that doesn't mean that you are going to be a good physician. In my experience, it makes for piss poor physicians. The people that excel and the ones that take good care of patients are the ones that are hungry to learn. You seem to need it spelled out so I will. I AM NOT ADVOCATING SPENDING YOUR ENTIRE LIFE WORKING FOR YOUR PATIENTS AND OTHERS. But, your job in residency is to learn how to be a practicing physician, you have an extremely limited amount of time to learn what you need.
#3 I am a starting PGY3 in Vascular Surgery. The IM residents that were in my orientation group are now the chief residents in their program. It is scary. Their program is the epitome of "clock in, clock out" medicine. Half the time you call, you get, "Oh we haven't rounded with the attending yet, I have no idea what we are doing." The other half of the time you get, "Oh, I'm the cross covering resident, I have no idea what you are talking about." I have on several occasions had to transfer a patient to the CVICU in the middle of the night because of something that should have alerted people 12 hours earlier.
Second...
It sounds stupid, but lets go back to pre-med personal statements. "Why medicine?" Or more specifically, "Why go to medical school?"
I think we can agree on a few basics...
#1 Medical school is extremely expensive. The financing and time costs are enormous relative to every other training path. There is no reason to go to medical school if you can be equally happy doing something else. The opportunity cost is just too damn high.
#2 NPs and PAs make good money with the opportunity to make a lot more with an enormous lifestyle benefit relative to residents and many (but not all) attendings.
Now, you may disagree, but if you don't actually know anything about how hospitals function or how medicine is practiced, your opinion's value is very limited. What are people looking for when they go to medical school? Job security? Money? Help people? Genuine interest in healthcare? Interested in the application of science on people's lives? All legit reasons to be interested in medical school. None good enough alone. You can get all of that in spades as a PA, NP or any number of Allied health professions (depending on what exactly your motivations are). You know what you can't get? MAXIMAL (not full) autonomy. Ultimate responsibility. How many people NEED that as a part of their profession? Certainly not everyone and probably not even a majority of medical students.
-------End general stuff that should really make sense to you....--------- Start personal reasons for not becoming a PA ----------
Why doesn't it interest me at all to be a PA? Because, I have the pathological need to be the master and commander (to the highest extent possible in a highly hierarchical and bureaucratic hospital) of my job. Because, when my patient isn't doing well at 5:30am and I've been in the hospital since 5am the previous day, I'm harassing the OR to give me a room to take them back and **** if someone else is going to stop me from being there. (clearly if I haven't slept at all, I'm going to ask someone else to step in and help, but I'm not going to leave.) Who are PAs?
#1 A PA is the first line responder in the CVICU managing complex drips and vents. Under the general supervision of an intensivist, but they are the person on the ground giving my patient the best fighting chance at surviving their pathology and what we as surgeons inflict on them. After the patient leaves the ICU to the OR or ultimately to the floor, their responsibility ends.
#2 A PA is the extra pair of hands doing complex open heart cases when an appropriate level resident/fellow is not available. After the patient leaves the OR, that PA's responsibility ends.
#3 A PA is the one that fills in the gaps that often happen after a surgeon talks to a family. Ensuring a smooth transition from active pathology to healing from surgery to recovery. They make sure that the patient's and the patient's family's needs are met and that they come back to clinic. After the patient leaves the hospital, their responsibility ends.
These are what OUR PAs do. They are not what ALL PAs do. I'm sure that this is colored by my personal experience. I can tell you this, if I had to pick one individual to run ICU care for my loved one, it would be one particular PA. They work extremely hard. They are well compensated. They have a very good lifestyle. They have the capacity to develop a very good and useful skill set that makes them in extremely high demand. They get from their jobs what a good number of medical students are looking for in their professional lives. There is NOTHING wrong with that. Why do I think a lot of my classmates would be happier as PAs? Because we bust ass and sacrifice a lot to be an MD. It is not benign and a lot of physicians aren't happy. There is a reason there is such a thing as "lifestyle specialties" and there is a reason why they are generally competitive.
Not everyone is suited to being a physician.
....There is a poster in SDN 
