Hello!
I've been reading forums for days looking for answers of my own. So I decided to register and ask away!
I am a current undergraduate student trying to figure out which path to take, PA or MD. I know I want to be in healthcare and have a strong desire for patient care. Both doors are open to me, which is nice but also makes for a difficult decision.
Some background.. I am already married and do wish to have children in the future. My husband and I have decided that he would stay home with the children (I am so grateful!).
I have been on the PA path for a few years but about every six months I freak out and go through the turmoil of thinking I need to be an MD. Luckily classes don't differ too much for me at this point but I just feel lost in the decision. I want to be a good mother and be there for my family but I have such an urge to pursue medicine. I will also be hopefully getting a scholarship with the NHPSC to pay for medical school in case you were wondering how my husband could stay home!

Okay here are some questions.

-When is the best time to have children on the MD route?

- How old is too old to start a family?

-Do you regret your decision to be a doctor and a mother? Do you feel guilty?

- General opinions about PA vs MD!!

I'm sure I have more questions but hopefully this will be a good start!!

Thanks.

Welcome, MD2BE?! What is the NHPSC?

I can try to answer some questions with my opinion... and as you saw on here there are lots of threads about the exact questions you have

-I think having kids on the MD route is hard anytime, BUT there are women here who have done it pre-med, during med school, during residency/fellowship, and in practice. It can be done anytime! I had my first during 4th year of medical school which was great - until I started intern year with a 4 1/2 year old and was pumping q3hrs. That was tough. Now I'm pregnant with our second and am an anesthesia resident. So far, not too bad. It's tough taking overnight call when you're nauseated and horribly tired - but really, nothing is fun when you feel like that. I just sucked it up and dealt. I think most residents do that. I will get 8 weeks for maternity leave and could take more if I wanted, although I have to make it up at the end (national anesthesia board requirements, not program requirements). Overall, my program is very supportive and has been great. And not just with the pregnancy, but also with being relatively family friendly. Just recently I had to call in another resident to cover for me for a few hours during a weekend call while I took my sick son (fever of 105) to the pediatrician. As long as you do your work people are happy to help (I came back to finish my call after my husband finished rounding, and offered to take another call from this resident to make up calling him in).

-How old is too old to start a family... well, we see lots of women in their late 30s or 40s starting families so it can be done! Maybe it will be more difficult but it is possible. Of course, you may also get tired more easily chasing a toddler around or doing round the clock nursing...

-Do I regret my decision - no. At least not usually. The mornings my son wakes up burning hot and I'm supposed to be working, then yes I do a little (see above). Or if he screams when I leave him at daycare... But I love my job. And usually don't feel guilty. If I wasn't working in a job I love I wouldn't be happy so I feel like I wouldn't be as good a mom. I don't do well being home all the time, so I think it's best for our whole family that our son goes to daycare and has other caregivers.

-General opinions about PA vs. MD... I think I'm biased since I did the MD route and it has worked out well. I think the good things about it are that you have lots of flexibility in what field you go into and you get exposure to all the fields during medical school. Of course, I didn't do PA training so I have no idea what that is like.

Good luck, and welcome!

sahmd- NHPSC National Health Professionals Service Corps is both a scholarship program (which is what I plan to do) and a loan repayment program. After you get accepted to med school you apply for the scholarship with the NHPSC. It is very competitive but I believe I have a lot of the attributes that they select for. Anyways, for every year they pay for your schooling (also a monthly stipend) you owe them a year of service in an approved health shortage area.

lyn2006- Thank you so much for responding to my questions!! I appreciate all of the response but what especially hit me was "If I wasn't working in a job I love I wouldn't be happy so I feel like I wouldn't be as good a mom." So very true! I never thought about it like that. As far as the parenting, yes from this site I have discovered these things are very possible! I just have this fear of being a second rate mother if I choose such an ambitious career. Reading about all of these women who are not settling because of motherhood is very reassuring.

Thanks again.

So I'll answer this with simple comparisons and based on the goals you have for yourself I hope it helps you decide:

1) TIME
Doctor route: 4 years med sch + 3-5 yrs residency + 1-3 yrs fellowship depending on what specialty you chose ex 4 + Internal Med (3), + 3 years pulm/crit fellowship = 10 years of training. No fellowship = minimum 7 yrs of training

PA route: 3-4 yrs of PA school +/- 1 year fellowship (if you want surgery or something similar) and get a job in any field that interests you (if available in your area) and essentially become a specialist without additional training.

2) Scope of practice: Limited as a PA and very dependent on the physician (s) you work with

3) Knowledge and skill: As a med student I worked along side PA students and there were no differences in clinical training but it was obvious that the depth of medical knowledge was not the same. However as a resident I've also gotten to work with seasoned PAs in the ICU for instance whose skills were remarkable. Most PAs learn the clinical skills on the job and over time become quite skilled and practical clinicians.

4) Liability: More liability on physician than on PA

5) Ultimately both are jobs and you'll be well compensated either way. I think for most people it becomes a question about the time involved in training.

6) Time at home: I am a mom and I went the doctor route and I have to say that I'm satisfied (during the times I work the 9-5 hours like any other working mom). As a resident, there are times I work long hours and do feel guilty because I may be too tired to play with the kids but I make up for that when my schedule lightens up. Remember that as PA your hours are in a way dictated by the needs of the practice you work for so if you join a busy practice, your life could still be as busy as that of a resident. You have to find and create your balance.

7) International Appeal: I had this debate as well in undergrad but I wanted to work internationally as well and not many countries recognized PAs that I knew of, so I went the doctor route.

Hope this helps.

Either before you start or after you finish! The universally worst times to have a young child are 3rd year of med school and 1st year of residency (so about midway through an approx 8-year training). Other than that, any time can be made to work, especially with a SAHD available. Just remember that once the baby is here, it will remain needy for quite a few years. (So eg 4th year of med school is generally chill, but then you have a still very needy 1 y/o in your first year of residency. However many women take a 'baby year' off after 3rd or 4th year, which can help with this problem.) If you are older, it's probably better to have them before med school or in years 1-2. If you are younger, it may be feasible to wait until later in your residency or after you finish.




I'd say that's a very individual decision. Depends on your fertility, your support system, and how many kids you want to have with what spacing between. Personally I think it's best to start having babies by 30 and finish by 35. Biologically, most people have reasonably good fertility until 35, and will still be able to get pregnant between 35 and 40. After 40 it's a big crapshoot. In general if you do happen to be someone who has a fertility issue, you have more breathing room to deal with the issue if you find it out earlier rather than later.

My personal concern is less with my biological fertility window, and more with the ages of my parents and in-laws, and how old I will be when the last child leaves the house.




Not at all, but I am in a very family-friendly fellowship position right now and I didn't have my first child until I was past the big training humps. Even still I had a fair number of hairy nights crying in call rooms with my first baby.



Sorry I know nothing about being a PA, so haven't much to say on this one.