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PA option

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9 years 3 months ago #75160 by snowflake
Hi everyone,

I've had a number of people PM me to ask me questions about PA school. To avoid responding to everyone individually, I'm answering all the questions here (if you have another one add it it and I will try to answer it). This might also be helpful for others as well rather than replying on an individual basis:

1. why PA over med school?
I've written pretty extensively about why I chose PA school over med school, so I'm not covering that here. Basically, the reasons come down to cost, flexibility (during school, after school, and in moving areas of medicine), and responsibility (I'm never in top command, so to speak, which means my job is less stressful). Another advantage I've noticed more recently is expectation--as a doctor I think many other doctors will expect you to have the same commitment (read: time commitment), and if you don't want to spend as much time at work, or be as available to your patients, you are seen as a "less dedicated" doctor. This might be changing somewhat, but I think there is still very much an old boy's club mentality. I don't think this happens with PAs. I think people expect that you do the hours you get paid for, but NOT to be constantly available to patients. This might also apply with knowledge--as a PA, the standard you're compared to is lower, which means if you can exceed this, everyone is impressed. (Impressed employers=great references=great job opportunities).

2. What area of medicine can you work in as a PA?
Any area. Really. There are PAs working in everything from family medicine to transplant surgery. Plus, you never have to commit--you can always change your mind.

3. I want to go to PA school as a back-up option for med school.
I wouldn't do this if I were you. Decide what you want, and then do everything you can to make it happen. You won't be happy in PA school if you really wanted to be a doctor, but are doing PA school because you ran out of options.


4. Do people respect you less as a PA than as a doctor?
Maybe. But then, people probably also respect you less if you want to become a family doctor rather than a trauma surgeon. My experience has been that patients generally like me (because I spend time with them, and actually have social skills--surprisingly, not all clinicians do), and the doctors I work with appreciate the help. There is surprisingly little negativity at my placements. The biggest source of negativity is probably from new doctors, who feel that they're competing with me for training time/work. (Although not all are negative--some are very nice and have become my friends).

4. What else is there to think about when choosing to go to med school or PA school?
Being a PA is a much more political role--you do have to be careful not to step on toes. I have found that it can be very difficult to explain what I am training to do without overselling or underselling the role. What I generally say is that the role of the PA is dependent on what the supervising doctor does in his/her scope of practice, what the PA knows and how much experience he/she has, and what is permitted by the hospital/law. The only across-the-board restrictions I know of are that a PA can't preform major surgery without a surgeon physically in the room, and various legal loopholes (a PA can't preform surgical abortions, I think, or write a death certificate. Big deal, in my opinion). I believe, but it can be very difficult to say, that PAs can work at the level of experienced residents, or even above this (I know that some doctors get very huffy about this)--but honestly, if you compared an experienced PA to a resident, and you didn't know which was which, I bet that you couldn't tell who was who. This is where it gets political, though, because it's impossible to prove without running your own mini experiments). One point of reassurance is that although PAs are generally trusted with a lot of responsibility, lawsuits very rarely come up for care done by a PA--this is why malpractice insurance for PAs can be so low. My theory for this is that anything that's potentially lawsuit territory is noted by the PA and the PA gets the doctor to help--I don't mind this at all!

5. Is a PA like a nurse?
Not really. It's not a hierarchy statement--I just haven't learned any nursing in my course, I'm not taught by nurses, and my job description doesn't overlap with a nurse's job description. Great nurses are the people who keep a close eye on patients, report any changes, and help deliver the patient care (e.g. administer meds, check vitals, etc.) The PA job description is much closer to a doctor's job description. If a PA isn't doing the job, a doctor would be doing it (not nurse), if that makes sense. Of course, this is different if you're talking about nurse practitioners.

6. Does PA school require the same pre-reqs as med school/how competitive is it?
Generally not, although check with the specific school. Some require more pre-reqs than others, although nearly all require some. The competition varies according to the program, although the most competitive schools admit between 1 in 8 and 1 in 10 applicants. For others, it's more like 1 in 3 or 1 in 4 (similar to most med schools).

7. When should I NOT go to PA school?
If you feel that you want to be the head person in charge of patients, you should not go to PA school (e.g. if you want to be completely in charge of your patients). Remember that complete responsibility also translates to a lot more stress. Personally, I would rather have complete responsibility for my family and kids and partial responsibility for my patients--I think if you try to do too many things you either 1. fail at one or more of them, or 2. sacrifice yourself in the process, and don't have time for the things you want in your own life.
However, I do understand that for some people it's a calling that they want to have complete responsibility for patients, and I respect this. Without these people, I couldn't have the job that I want!

8. What's the catch?
You're not called "doctor" for whatever that's worth (although patients still call me doctor all the time and I have to correct them), the earning potential is not in the same league as the highest paying areas of medicine (although it's similar to the lower paying areas--with years of experience, from $150-200K), and it's a more political role (as above).

Good luck and ask me more questions and I'll answer them here.


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9 years 3 months ago #75162 by 1buzymom
Thank you so much for the in depth response! I was looking into becoming a doctor, but realized that I wanted a more flexible career so that I could be with my family (which is my number one priority). I do have friends who are doctors that have tried to persuade me to become and nurse and go the nurse practitioner route, but that is just because they are still unfamiliar with what a PA is and what a PA can do. But, I have another friend who is a PA and she loves it! My question for you is:

1. I'm an teacher making the career change. Will I have a difficult time getting into PA school, because I am not a health major? I know that most PAs used to be nurses or paramedics.

2. Do PAs practice in OB/GYN? I would like to work in that field once I become a PA, so I wanted to know if there are openings there. I would do Nurse Midwife, but I want flexibility to move around.

Thanks so much!!

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9 years 3 months ago #75175 by snowflake
1. I'm an teacher making the career change. Will I have a difficult time getting into PA school, because I am not a health major? I know that most PAs used to be nurses or paramedics.

No, this would not make it difficult for you to get admitted as long as you can demonstrate your interest in healthcare and medicine through other types of experience (volunteer work, etc.) In the past, most PAs were nurses or paramedics, but this is changing now, as people from divergent fields are attracted as well as recent graduates. Every PA school will ask you to have experience in health care (some schools require more than others), but this doesn't have to be as a full time job. For instance, you could get a volunteer job at a hospital or care home on the weekends for awhile, or during the summer months (if you're not working full time in the summer as a teacher). To be honest, I wouldn't go to PA school without doing this, admission reasons aside--I think that many people have ideas about what working in healthcare is like, and the reality doesn't necessarily live up to this.

One piece of advice I was given is that quality is more important than quantity when it comes to healthcare experience, and continued work over a long period is better than a short "blast" of volunteer work. If you're thinking about moving into a healthcare field, I would start now--speak to hospitals, dr's offices, care homes, etc. and ask if you can come in for a few hours/week. It's likely that the jobs you'll be doing won't be particularly medical in nature, but this doesn't really matter. It's more about being there in a healthcare setting, seeing how the system works, and chatting to patients. You might also ask hospitals if they do visitor programs (some hospitals will recruit volunteers to "befriend" lonely patients who don't have anyone to talk to--e.g. come visit them for a few hours/week. I think this would be fantastic experience, and I think this would go down with admissions teams much better than just shadowing doctors, since you're actively interacting with the patients and their families. If you are a member of a religious group, you might try this route too--sometimes churches, etc. run similar "visitation" programs for lonely sick people, either at hospital or at home.

Another issue to consider is that particularly with hospitals, you'll have to go through a long process involving interviews and criminal records checks before they'll let you start--it's not as simple as calling them up and then arriving the next day. Keep this in mind--another reason to get started now!

Furthermore, I actually think that your teaching experience would be very relevant, and you should play this up--a lot of practicing medicine IS teaching--teaching people about their conditions, medications, risk factors, etc. I think that you should highlight this in your application!

2. Do PAs practice in OB/GYN? I would like to work in that field once I become a PA, so I wanted to know if there are openings there. I would do Nurse Midwife, but I want flexibility to move around.

Yes! I'm also very interested in OBGYN, and I'm a member of this group: www.paobgyn.org/ . The only difficulty with OBGYN *might* be doing deliveries on your own--regulation will probably depend on the hospital (as the APAOG website explains). Of course, the downside to doing deliveries is that you're pretty much on call constantly--I'm not sure if I would want this anyway, and might rather do office work and assist during scheduled C-sections. If you were very sure that you wanted to do deliveries, this is definitely an option as a PA, but you might have to choose your hospital more carefully, or be prepared to put up a bit of a fight to make your case.
You're right that as a nurse midwife you wouldn't be able to move around if you got tired of delivering babies--this to me is a major disadvantage.

Another way to get more experience as a PA in OBGYN (and thus, make it more likely that you would be allowed by the hospital to do deliveries, if that's something you wanted to do) would be to do a residency in OB/GYN, such as this one: temp.obgynpanet.officelive.com/default.aspx

Let me know if I can help further. I think being a nurse practitioner is a good route as well, but this makes much more sense to me if you're a nurse already.

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9 years 3 months ago #75176 by FuturaDoctora
Thank you so much for giving us insight about P.A. route :)
Since I had been trying to PM you before, I though that you had your mail box full! But, thanks for your time and your wisdom words of advice that I take very seriously since I am trying to make a life-change decision related to this topic.
You have such a deep-knowledge on this area!

Thanks for sharing that with us.


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9 years 3 months ago #75178 by snowflake
You're welcome! Sorry I'm slow at responding to PMs--have been busy lately! Ask more questions here though if you want. I understand that it's a huge decision!

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9 years 3 months ago #75271 by 1buzymom
So I talked to my husband and he has given me the "go-ahead" to do PA and fulfill my pre-reqs full-time. (Didn't really need his permission, but being a wife/mom I wanted to make sure that it would be financially ok..:) Well, now that I have pondered (for years) now I am nervous. I'm dreading having to take out loans, b/c I didn't have to do that for undergrad, but nevertheless, I'm ready to take the plunge! After reading your (snowflake) previous posts, the reasons that you were pursuing medicine (prestige in being called Dr.) were my same reasons. But after research, I think PA is for me. Here in Michigan, there are 3 hospitals that let PAs deliver babies. Also, I have a friend who is a PA and is making $125, 000--which is GREAT to me!! I love the fact that PAs can work part-time (and probably make more part-time than I did as a full-time teacher) and in different specialties. I am a mom of 3 so I will hopefully still be there for the milestones in my children's lives--which I know is VERY important and priceless! Thanks again for your input and insight.

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