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PA to DO at LECOM, is it worth it?

6 years 4 months ago #86327 by ElliePA
Hi everyone! I have been viewing these forums for a while! Here is a little bit about me and my situation: I am currently a PA student. Before going to PA school I was an echo tech (cardiac ultrasound tech). I loved ultrasound, but my hunger for knowledge and desire to broaden my scope of practice and do more for my patients lead me to PA school. I originally wanted to go to med school, but my hubby and I could not fully commit to the time in training, moving around for residency/fellowship training, plus me having to take the time to finish pre-reqs. The pre-reqs for PA school are different than med school. So, since PA school was only 26 months and I could apply right away I decided to compromise take that route. When I applied to PA school I was 22 years old. I will be 24 when I graduate PA school. My hubby and I have been married for 4 years and we don't have any kids yet.

Though I really enjoy PA school and I love that I will be able to practice medicine when I am done, I still feel the desire to become a physician. I love learning and deepening my knowledge. I would go to school forever if it wasn't so expensive! :) Plus, I feel that long-term earning potential is becoming an issue for me, considering my student loan debt. I am really good friends with a Cardiology PA and a Cardiologist and they both feel they have very similar jobs with similar hours but my PA friend makes 1/3 of the salary of the Cardiologist (they are both part of a non-invasive outpatient cardiology practice). They see the same amount of patients and have similar on-call schedules.

So here is my dilemma: I am considering applying to the PA to DO bridge program at LECOM. This program takes one year off of med school, so you only go 3 years, then you complete an osteopathic residency. But, since I went to PA school, my hubby and I have a total of $180,000 in student loan debt (our undergrad plus PA school). This amount would at least double after med school. We live very frugally and we want to be out of debt as soon as possible. As a PA, I would make around 75k starting (with my 180k debt). As a DO I would make around 200k starting (depending on specialty, I want to go into cards though) (with about 360k + in debt). Though my debt would significantly increase, my debt to income ratio would still be better long term if I went the DO route.

I just want to know if you guys think this choice is worth it. I feel guilty for taking up a spot in PA school when I truly want to be a physician. And...when crunching numbers the financial burden sounds scary, but manageable if we try our best to put the majority of our income towards debt. I figure if we live on 50k or less for a few years when I am done with residency/fellowship then would should be able to knock out our debt. My hubby is a pastor and does not bring in much income (~25k/ year). We have talked this over a million times and he said he is 100% supportive of me to pursue my dream. I just don't want this to be a huge financial mistake! I will be 30-33 years old when I am done if I apply when I finish PA school (and if I get in). Any input would be great appreciated.

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6 years 4 months ago #86330 by mohm
I don't have a lot of input except to say that I would make sure your assumption that you would make $200k is realistic. I know many physicians including myself that make much less than that. If you are counting on doing a certain specialty, I would also think about the variables outside of your control such as the competitiveness of the specialty as well as the time spent in fellowship with a lower income.

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6 years 4 months ago #86331 by asunshine
I would echo what mohm said. It would take far, far more than a few years to pay down your debt, too, even if you lived extremely frugally. If you have kids, after TEN years of training, you will likely be dying to buy a house, save for retirement/college, pay for good health insurance/schools, and generally live off of more than frozen pizza.

I am a resident, and if I did not use income-based repayment, my ENTIRE take-home pay (after benefits) would go to paying my student loans alone. And I owe maybe half of what you would owe. I would love to pay off my debt a few years into practice, but I'm realizing that it's going to be impossible (and some financial types would say inadvisable) to do so.

All that being said, please do NOT go into medicine for the money or prestige, but rather because you couldn't imagine doing anything else--you have to love the people you take care of, the mental taxation, and the constantly changing environment that goes with it. If medicine is what you want (and you have the drive, interest, support and ability), you should do it.

On a philosophical level, I *hate* that very bright and capable people with financial concerns are getting pushed away from medicine. Personally, I want the best and brightest taking care of me when I'm sick--maybe it will be you one day!

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6 years 4 months ago #86334 by lyn2006
It's true, that changing to medical school instead of PA school to make more money may not be a great idea. If you think you'd never be happy being a PA, and would ONLY be happy as a physician - then go for it. But, your career can be very fulfilling as a PA (from what I've seen) and then you won't have to double your debt.

My husband and I are both residents and have a combined debt of 400k+, which is rising each year even though we are doing income based repayment. Luckily we will both have physicians' salaries at the end of the training and I'm sure we'll be able to pay it off... but we are looking at $4000/month payments (or more) in order to do so unless we extend our repayment period beyond the standard 10 years. And with interest at 6.8% I'd rather not do that.

Re: going into cardiology, that is an additional 6 years of training after medical school. It is not the easiest fellowship to get into either. Some people feel they need to do a chief resident year (an additional year of training). It's a long haul...

Good luck!

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6 years 4 months ago #86336 by PAmom2be
Ellie--read this article suggesting that female PAs make MORE money over their careers than female doctors: scienceblog.com/55548/most-women-make-mo...stants-than-as-docs/ I'm not sure where you're getting the figure $75 but that sounds like a starting salary in a not-so-high paying field (and, remember that 1 year out of med school you would also be making a starting salary, not the $200 you quote.) Furthermore in high paying specialties, you definitely could make $200 as a PA. I heard of an entry level interventional radiology job recently that pays $175.
However, money is not everything. You will have no difficulty finding people (mainly doctors, mainly bitter doctors, mainly bitter female doctors who feel that they sacrificed everything to get where they are professionally) who will be more than happy to inform you that PAs don't practice medicine. This can be frustrating (what defines "practicing medicine"? Making diagnoses? Examining patients? Ordering and interpreting investingations? Prescribing medication? Tick, tick, tick, tick. Please spare me your angry rants, mommders, I do not think I should practice without the support of a doctor, I do not think that PAs are the same as doctors, but I can and do practice medicine.. I digress.) For me, as for many of my colleagues, becoming a PA was primarily a lifestyle choice. My advice? Go talk to talk to your faculty. You may be surprised how understanding they are. Trust your own ideas and values over mine or any stranger on mommd. Become a doctor if that is truly what is best for you, but think twice if your motivations are primarily financial. (by the way, I'm a PA who works in ortho and trauma surgery. I want to be a mommy someday and have been lurking around this site for awhile.)

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6 years 4 months ago #86337 by ElliePA
Thank you, everyone, for your replies! I really appreciate it!! I want to apologize if I seemed like my primary reason for considering going to med school was to make more money. Though finances are involved, money is definitely not my motivating factor. I truly love medicine and I love my patients. I know I will be mostly happy and fulfilled as a PA, but I also know that I will always wonder about med school. However, I am not sure pursuing med school is worth the financial risk. Our final debt of 180k from undergrad and PA school already stresses me out big time. My hubby currently brings in between 15-25k/year (he is in ministry), and here in MT the starting salary for PAs is about 75k for new grads, 6 figure salaries even with experience are hard to come by. Some PA positions are even hourly, starting at around $35/hr. I know that sounds sad, but that is how it is around here, and I do not live in a city with a low cost of living, so it bites. Like I mentioned in my first post, I was a cardiac ultrasound tech before and some techs that I worked with who only had a few more years experience easily make $35/hr some even more (our lead tech made $42/hr + call pay). It is just a bit depressing that I will be a midlevel provider (with an extra 100k in debt + a master's degree) and make the same income as my previous profession with my little 2-year tech training. Now, I obviously did not become a PA for the money, but because I love medicine and I wanted to broaden my scope of practice and be directly involved in my patients' care. I'm just ranting :)

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