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Old 13 September 2018, 16:13
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Becoming a PA, is it worth it?

So my 17 year old neice now is seriously talking about becoming a PA. Her motivation: very high salary and less time in school than being an MD or Vet she had talked about.

But looking at the requirements, would not she just be better off becoming a MD? Seems you need the Bachelors, with heavy science background, then a Masters 2 year program. And then need work experience. Why not just knock out two more years and get the MD?

What are the advantages and disadvantages of going PA over MD or even. nurse practitioner or CRNA.

As she is starting to decide on colleges and courses of action, some input is appreciated.
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Old 13 September 2018, 16:28
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Since she has not chosen a path she could...

Go to nursing school, work, learn, then head through an NP or Certified Registered Nurse Anesthetist program.

Cost of the total education versus salary.

Explore it all with her and guide her to do what she loves.
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Old 13 September 2018, 16:32
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My friends Thai wife went that route (she had been a nurse in Thailand before moving here after marriage). Couple years working as a nurse in the USA then masters program in CRNA. . $25k sign on bonus and started her out at $145 a year! And that is in low cost of living Indiana.
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Old 13 September 2018, 16:41
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Since she wants to be in health care, at this point I would sell her on nothing other than a BS in sciences.

Biology, chemistry, physiology.

CA requires an AA/AS to be licensed as an RN. BSN programs are accepted for licensure but not required.

If she wants to be a Physician look at Osteopath schools as well.

But, degrees are needed, MCAT’s taken.
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Old 13 September 2018, 16:58
notdeadyet notdeadyet is offline
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Originally Posted by leopardprey View Post
But looking at the requirements, would not she just be better off becoming a MD? Seems you need the Bachelors, with heavy science background, then a Masters 2 year program. And then need work experience. Why not just knock out two more years and get the MD?
I went through the same decision process and opted the MD route. Not the best choice for everyone.

The PA route is BA/BS + 1.5-2 years master's --> work. You can do further advanced specializing, but don't need to.

The MD route is BA/BS + 4 years medical school + 3-7 years residency. You come out with typically over double the debt that you'd incur for a PA program (~$200-300K). The 3-7 years residency are technically for pay, but you're earning $45-60K/year. Sounds like a good bit of money, but often times you are working 80 hours per week (literally) and you are pretty much an indentured servant.

Advantage of PA > MD is lower debt and a bit benefit that you can work in any field. If you get tired of working as a PA in a family clinic, you can go work in a neurology clinic. You can work pretty independently in many fields, but are very restricted or excluded from others (PAs function as PCPs all the time, work in Derm offices but the Dermatologist is going to be point on many cases, and you will not be doing neurosurgery).

Advantage of MD > PA is higher pay and you will be head of care teams. Complete independence. Big downside is that you are restricted to the specialty you spent 3-7 years of residency in. If you want to switch, you start over.
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Old 13 September 2018, 17:01
notdeadyet notdeadyet is offline
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Also, if she is thinking of going the PA route, I'd strongly recommend Nurse Practitioner > PA. For various historical reasons, PAs are utilized as physician substitutes a lot more than NPs (at least in the Army) but this isn't the case in the civilian sector. NPs have better job opportunities, particularly in the hospital setting. There is a HUGE union pushing nationally for NP scope of practice and independence rights. You don't have that pull from PAs. Again, no disrespect to PAs, but starting from scratch and staying civilian, I'd find it hard to recommend PA > NP.

You can also become an NP cheaper. Many programs are out there that will train you through RN, have you obligate to two years, and pay for your NP training.
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Old 13 September 2018, 18:31
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Originally Posted by Expatmedic View Post
Since she wants to be in health care, at this point I would sell her on nothing other than a BS in sciences.
For a 17 y/o this makes the most sense. If she goes straight through she'll be ~24. with 2 years of practice as a PA she'll be 26-27. She can go to med school then if she isn't getting where/what she wants as a PA. She can be an MD easily (time wise) by 35 and have 30 year career.

There is also a fairly good chance she'll completely change her mind while in college. You can bend a science BS in a lot of directions. My dad went BS in Chemistry to MS in Marine Bio to MD. That's probably harder to do nowadays than in the 50s but I'd really encourage her to focus on the 7 meter target.

If she considers the NP route at all I would encourage her to become and RN and get significant clinical experience before going NP. I know NPs who are absolutely top-notch and I know NPs who probably shouldn't have become RNs to begin with. The whole idea behind NPs was to take experienced RNs and train them to operate more independently. The operative word is "experienced". However, to my knowledge there isn't any "X years of clinical practice required" for NP school. Consequently you can wind up with an NP who is supposed to be able to practice independently who lacks the clinical knowledge or judgement to do that.
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Old 13 September 2018, 21:38
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She will need to decide what role she wants to fulfill. Hard to do at 17 with no real view into what each of those professions does.

Get in college. Take science classes. Do well at them. Get a gig at the local hospital, see some of what's out there. If still in high school the Medical Explorer programs can be illuminating.

With a little time, the path becomes much more clear.
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Old 13 September 2018, 22:20
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Have her shadow a few of the providers for a couple of days each. PA, NP, MD, DO, CRNA.

Volunteer work looks good for college admissions and for follow on schools and this will get her exposed to various disciplines.

Have her consider Rad. Tech., RT as well. These are technical career paths but pay well.
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Old 13 September 2018, 23:01
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well...as a PA of 20 years I see some misnomers in the answers above.
PA's and NP's are two COMPLETELY different animals. PA's are more procedure and healthcare focused, NP's are more "specialty / whole health" focused. This was one reason why NP's failed miserably during the attempt to substitute them for PAs on PROFIS deployments. They are (amazing) nurses in their field, but they are rarely "doctor substitutes" as PAs are utilized.
While this can indeed be argued, I am not up for the argument and am simply stating my (and the US Army's) experience.
Advantage PA? LESS MALPRACTICE INSURANCE. I'm talking...90+% less than a physician. Less call, better quality of life,. less BULLSHIT. She can still make 120-160K a year depending on what she WANTS to do (and as mentioned - if she doesn't like specialty "A"...she can go work at specialty "B")...I looked at becoming and MD multiple times....the extra letters (and extra debt) simply weren't worth it for me. With the advent of Obamacare and treating the indigent....many physicians are struggling, retiring early, or quitting medicine altogether because reimbursement is so low. Hell, Tricare pays SEVEN CENTS on the dollar!!! Many employment programs will pay off your debt from PA school if you sign on to them for 2 years. It is really a deal that is so popular it is hard to ignore.

CRNA? ABSO-FUCKING-LUTELY!!!! IF you can get into the program, are good (REALLY GOOD) at math, and can afford 30K a year in malpractice insurance....that's a pretty big chunk out of your $145 a year (GROSS) to start. Not to mention call, extended cases, deaths, complex surgical interventions, OR time, OR cases you have no control over pre-screening because they "came up/down from 'someplace' and need immediate intervention"...
Life of a CRNA is NOT all that glamorous...
I was happy i CHOSE to STAY a PA....even after I took my MCATs and was accepted to medical school.....I turned down that opportunity. It was probably one of the smartest decisions of my life given my age and station in life at the time. It has continued to serve me well.

Should you OR HER have any questions....feel free to PM me and I will send you my cell.

My utmost respect...
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Old 13 September 2018, 23:19
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I'm not a PA (I'm a former 18D that sometimes regrets not becoming a PA)...so, I think ussfpa covered the PA angle pretty well.

You need to talk to her about the "whole life" aspect. Our jobs aren't the sum total of who we are and what we do. What does she want to do outside of work? If she has a general idea of what she wants to do in her "down time", and where she wants to do it (geographically, whether CONUS or OCONUS), she should factor that in. Some jobs in medicine offer more opportunities to live in the middle of nowhere than others, some medical jobs are in high demand overseas, etc.
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Old 14 September 2018, 06:28
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There are lots of PA's & NP's here. I understand the PA's make a real good salary. The more experienced the better the salary. They don't spend those extra years going thru med school.

It seems common for them to hold the Fort down while the DR's are off doing surgeries and such.

They can write most scripts a DR can except certain scheduled drugs.
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Old 14 September 2018, 09:22
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They can write most scripts a DR can except certain scheduled drugs.
Depends On the State where you are practicing.
I have had my own DEA number since 99 and have been able to write for all schedules in each state I have worked, including now here in Florida
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Old 14 September 2018, 09:43
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Originally Posted by 1RiserSlip View Post
There are lots of PA's & NP's here. I understand the PA's make a real good salary. The more experienced the better the salary. They don't spend those extra years going thru med school.

It seems common for them to hold the Fort down while the DR's are off playing golf at the country club with their trophy wife.

They can write most scripts a DR can except certain scheduled drugs.
....
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Old 14 September 2018, 09:48
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Some really good advice and comments so far. Thank you.

Had talk with her last night, and she is also now seriously considering enlisting in the Coasu Guard or Air Force and going into some medical field within those branches. Then having her college paid for to go further. I told her I think that is an excellent idea. She gets all As and Bs, in college prep courses and is quite athletic. 5' 8" tall and is on swim team and tennis teams, and this summer she worked as a lifeguard at the city pool. I think would be great for her to go into the Coast Guard for four years, then get out and pursue a nursing degree, then onward to PA, NP, or CRNA program.
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Old 14 September 2018, 10:31
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My two drachmas (I am a RN):

Operationally where I work, there are few differences between advanced providers (PAs and NPs). A few, but not many. Money is about the same, they can write the same scripts.

Most NP programs do require some experience; some do not. Nursing has had some very interesting hybrid programs (RN-to-MSN/NP, bypassing BSN, etc).

Took MCATs, got into med school (UNC-CH), but I would have been close to 40 by the time I got out of residency, and my wife and I didn't want that. I wanted to do CRNA, shadowed a few, hated every second.

Nursing is a great gig, the number of jobs is only going to get bigger.
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Old 14 September 2018, 10:50
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Young kid is, neighbor's son....27 years old....just got married....just graduated dental school....$540K in debt.
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Old 14 September 2018, 11:18
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Young kid is, neighbor's son....27 years old....just got married....just graduated dental school....$540K in debt.
Have recently heard that as well, from a retired dentist that is a shooting client of mine. He was telling me this several weeks ago, 1/2 million in debt. He still teaches a class every now and then. He is aghast at what new Dentist are acquiring in debt. Insane!

Now you know why every time you go to the dentist they are always trying to get you to do extra stuff!


Indiana University Medical School here is $34k a year. So if add in around $1000 a month for living expenses, that comes out to around $178k.
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Last edited by leopardprey; 14 September 2018 at 11:26.
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Old 14 September 2018, 12:01
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LP,
We had a similar discussion on the board several years ago. There were some good posts on the pros and cons of going PA vs MD.

Long story short, the decision should be made with significant attention paid to what kind of career she wants to have. Working in the OR as a PA isn’t in the same ballpark as being a surgeon. For both good and bad reasons. There are many specialties where being a PA carries all the job enjoyment without the time and financial commitment.

How much income is enough? How much does she want to work? And most importantly, how much ultimate responsibility does she want to have? If her grades are good enough for Med school matriculation, then she will have to ask those questions. If her grades are not good enough, then the decision becomes easier.

American MD medical schools remain the most competitive schools to get into. Vet school used to be at least as hard to get into, but that trend is no longer true. Talent always follows the money, and a career in medicine remains a virtual guarantee of decent income and job stability. Maybe not as true as it was 20 years ago, but still solid.

Please check out the thread for further commentary. My opinion has not changed in 6 years.
http://www.socnet.com/showthread.php?t=113262
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Old 14 September 2018, 14:20
Keganswar Keganswar is offline
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NYU is offering free tuition for all medical students

Something I have been following for a year or so as my daughter is interested in a medical field. The school raised somewhere in the ballpark of 640 million dollars to pay for free tuition.
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