PA versus MD

[EarnMoneySleeping]

I know someone posted a similar thread earlier, but I'd like to start a discussion about the pros and cons of a PA vs MD in general, as opposed to PA as a backup to becoming an MD.

A quick background about myself - I'm a 3rd year Northeastern University (UG) Health Science student with a GPA of about 3.8. I'm an EMT-B getting moderate amounts of experience working with a private Ambulance company (including 911 not just dialysis transfers). I also have some phlebotomy and research experience.

My dilemma is really in deciding what would be the best route for me. I'm truly torn as whether to pursue PA or MD/DO. Some aspects of the decision would be personal to me, but as the PA position becomes more prominent, I feel like both fields are changing significantly. This is what I've laid out so far in terms of Pros and Cons - Other opinions or ideas appreciated!

Pt. contact: PA's can spend more time with patients than MD's while MD's tend to have too many patients, and are too busy with billing matters to have significant pt contact.

Independance: PA's must work under a doctor's license. This isn't going to change, but in most states PA's are able to prescribe and diagnose quite liberally. MD's of course can operate under their own license and have much more flexibility in career choice.

Mobility: PA's can switch fields more easily than MD's - they can learn on the job while MD's would have to complete additional residencies. The MD is more widely recognized though.

Cost & Length of School: PA: about 2 years and $30,000. MD: about 4 years + residency and $100,000+

Salary: PA's make a comfortable salary (70k-100k roughly), while MD's make a comfortable to extremely comfortable salary

Liability: less for PA's, more for MD's

Recognition: We can't deny this as a factor..it's nicer to have MD at the end of your name than PA

Education: PA school focuses more on the practical "nuts & bolts" of medicine whereas Medical school will give you a lot more background info (some useful some useless) including histology and more laboratory science.

Personal/Professional Satisfaction: PA's seem to be happy with their job and I have only heard of several that went back to medical school after being a PA. However, and this is my biggest worry, I don't know if I would ultimately be satisfied without "being all that I could be" and going for the MD.

To sum it all up, I feel like PA would make the most sense economically and even in terms of lifestyle, but it also might nag at me for the rest of my life that I didn't go for med school. Any thoughts?

[DOC.p]

PA's and MD's do not compare in a level of understanding...give a PA the USMLE, see if they can pass it.

Don't get me wrong, PA is a great career...I have friends in it now and I've met many clinical students along the way. As far as a career goes, I don't think anything compares to being a physician in the medical field.

[sheikh1]

I like PA's because they do all the work for me, and the end I will sign off.

[joshalicious]

PA's and MD's do not compare in a level of understanding...give a PA the USMLE, see if they can pass it.

Don't get me wrong, PA is a great career...I have friends in it now and I've met many clinical students along the way. As far as a career goes, I don't think anything compares to being a physician in the medical field.

A PA in the field for a while will have just as much or more understanding than some doctors. As an example - I know a cardiothoracic surgical PA who was asked to teach CT fellows at the Medical College of Wisconsin.
No question though that a newly graduated MD will have much more understanding than a newly graduated PA.

....this PA said he preferred PA over MD because of the freedom it gave him to practice with very little concern over malpractice or lawsuits. But to each his own I guess.

[leadsled]

I think going to a foreign medical school has too many potential career risks. eg. not getting a US residency, not getting a US license, having $100k+ in student loans and not knowing you'll be able to pay them back, etc. I've seen a few go this route and never get a residency. Very demoralizing!

Try to get accepted to:
1. a U.S. M.D. medical school.
2. U.S. D.O. School.
3. U.S. PA school.
4. Top notch foreign medical school with a proven track record of:
a. USMLE pass rates.
b. US Residencies for its graduates.
c. Licensure eligibility in all US states.
5. US RN school then FNP licensure. (In many states better license than PA)
6. Try another area of health care.
7. Gamble with a mediocre foreign medical school.

[DOC.p]

I think going to a foreign medical school has too many potential career risks. eg. not getting a US residency, not getting a US license, having $100k+ in student loans and not knowing you'll be able to pay them back, etc. I've seen a few go this route and never get a residency. Very demoralizing!

It depends where you go, it isn't as risky as you make it out to be when 20-25% of licensed physicians in the US are IMGs or FMGs

[sheikh1]

They should compare PA's and nurses not doctors.

[EarnMoneySleeping]

PA's may be assistants to doctors as nurses are in a way, but they're trained in the medical model like doctors are, not the nursing model, so I would argue that PA's are much more similar to MD's than they are to Nurses...

I think my biggest concern is that the majority of primary care is shifting to PA's while doctors are left more with specialties and managing large numbers of patients from afar. I'm not denying that a physician would fare better on the USMLE, but I suppose I'm not content with the direction the physician profession is taking, at least in this country.

[stephew]

PA's and MD's do not compare in a level of understanding...give a PA the USMLE, see if they can pass it.

Don't get me wrong, PA is a great career...I have friends in it now and I've met many clinical students along the way. As far as a career goes, I don't think anything compares to being a physician in the medical field.

well i don think that's a fair way to approach the issue. give anyone a couple years out of basic sci and see if they can pass the step one. few could without major study. Besides no one becomes a doctor so that they can pass the usmle. its the other way around.

now if youre saying that MD's get more conceptual training, this is true and the big difference. PAs are trained in the fundementals of the clinic. They often, for htis reason, shine next to med students starting their first clinical year. In my internship we loved when we had PA students as they hit the ground running in clinic where as MD students were raw; the PAs trained for that part longer.

In practice, ultimately things can vary. First of all MDs have more autonomy and make more money. However some PAs wil be more talented than some MDs and vice versa. PAs tend to have more of a 9-5 job than MDs, but of course osme MD fields are more 9-5.

Its a complext thing and for many its the choice of being "a professional" or not. Its often less an issue of ability or intelligence.

[stephew]

woah there nelly; the truth of that assmeent has a LOT to do with where you go to school offshore. Is it a good school that only takes people likely to pass boards or not? If you succeed in being an MD you'll be able to pay off your loans as your income is much higher than a PA. Getting a residency wont be an issue if you graduate (unless you shoot for something too competitive given your CV). Licensing isnt an issue if you have the foresight to chooose a school with no licensing issues.

If you approach this with marginal inteligence you wont have those problems.

THer eis no quesiton; go to a US allopathic school if you can; their either a good DO or Offshore/international school. Or be a PA. that's an alternate route.

I think going to a foreign medical school has too many potential career risks. eg. not getting a US residency, not getting a US license, having $100k+ in student loans and not knowing you'll be able to pay them back, etc. I've seen a few go this route and never get a residency. Very demoralizing!

Try to get accepted to:
1. a U.S. M.D. medical school.
2. U.S. D.O. School.
3. U.S. PA school.
4. Top notch foreign medical school with a proven track record of:
a. USMLE pass rates.
b. US Residencies for its graduates.
c. Licensure eligibility in all US states.
5. US RN school then FNP licensure. (In many states better license than PA)
6. Try another area of health care.
7. Gamble with a mediocre foreign medical school.