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Guest Post: PA vs. MD with The PA Platform

Hi there!

I'm Savanna, and I'm a physician assistant. I went to the University of Georgia for undergrad (and I wish The Organized Undergrad had been around then!), and majored in Biology. I then went straight into PA school at Augusta University and graduated in 2014. I've been working for 2 years as a PA in dermatology, and I absolutely love my job. For anyone considering becoming a PA, I think it's important to also consider medical school so you can make a well-informed decision about your future profession. To be honest, the roles are very similar, but that can also depend on the setting and specialty you are in. The training is very different though. I've seen both paths first hand because my husband was going through medical school while I was in PA school, and he's now in his first year of residency.

I've done a similar post on my website, The PA Platform, that you can find at this link. In that post I compare the schooling and actual job of a PA and a physician, so here I want to just give you a breakdown of pros and cons for each job.

Physician Assistant Pros:

  • Shorter schooling – PA school is typically 24-36 months, whereas medical school is 4 years followed by 3-12 years of residency and fellowship. That's a significant difference! This was ultimately what made me pursue PA instead of MD. Keep in mind that while the schooling is shorter, it is very intense and you are in the classroom for longer than medical students while you are there as a PA student.

  • Less expensive – Part of this has to do with the length, but PA school is typically less expensive than medical school, especially if you can go to a public program as an in-state student. The return on your investment after graduating is very good as a PA.

  • Ability to change specialties – This is a huge benefit of being a PA. I work in dermatology right now, but I could just as easily switch to cardiology tomorrow. I would need some additional training, but PAs do this often. This lateral mobility may interest you if you know you want to be in medicine, but if you aren't sure what area. Physicians could potentially change specialties, but that means taking a pay cut and going to another residency for a minimum of 3 years.

Physician Assistant Cons:

  • No residency training (usually) – Residency is a time after medical school of intense training where you really learn to be a doctor. While there are a few short residencies for PAs specifically, it's not something that's typically done or expected. Most of the training for PAs happens on the job with the supervising physician. That's the one thing that I sometimes wish I had from medical school, but I'm lucky to have had great training from my supervising physicians so I don't feel like I missed out too much.

  • Constantly having to explain what a PA is/does – Every single day I get asked questions like this - “So what exactly can you do?” “What can't you do that the doctors do?” “When are you going to be a doctor?” It can get tiring explaining my job and that I will never be a doctor, but I do appreciate my patient's inquisitiveness. In my role, I do pretty much everything that the physicians do, so I'm also fortunate in that way.

  • More requirements for acceptance into a program – Both PA school and medical school are competitive for sure. Medical school does not have the direct healthcare experience requirements that most PA schools have. PA programs want you to have some real life experience before going into the program, where most medical students are coming straight out of undergrad. If you're on top of things, you can get the experience you need for PA school during undergrad and then go straight in as well.

Physician Pros:

  • Higher salary – Although you may have more student loans, after residency, you will be making a nice salary. It's not quite as lucrative as in the past, and insurance changes are limiting this more and more, but at the end of the day most doctors make more than most PAs. That's not saying that you can't do well financially as a PA, but just don't be upset when you aren't making the same as your supervising physician.

  • More in-depth didactic phase – There are some subjects covered in medical school that are not even mentioned in most PA schools, like immunology and embryology. Medical school typically reviews some of the subjects that were covered in undergrad, whereas PA school jumps right in to clinical subjects and only reviews Anatomy and Physiology.

  • Ability to own a practice – This could be a pro and a con because there's a lot of hard work that is involved in owning a practice. There's also a caveat that in some states PAs can technically own a practice, but you would still need a physician to be involved to some extent.

Physician Cons:

  • MCAT – This is a beast of a test, and your score is a huge determinant on whether you will be accepted into medical school. I chose to avoid this altogether by going to PA school, but just know that it's expensive, and you'll want to prepare early and take it with enough time to possibly retake it if needed for medical school

  • Competitive nature – Medical school is very competitive. You have to be involved in extracurriculars and research, and do well in coursework and clinicals to be able to do the specialty you want to do. If you aren't able to succeed, you may end up in a specialty that isn't what you went to school initially interested in.

  • Position determined by board scores – There are tests in medical school called “Steps,” which determine what residency you can do. For dermatology, you need to score in the top 1% to be competitive. You have to be open to the possibility that these tests may disqualify you from certain fields, or may end your medical school journey before you would like for it to end.

A common pro that you'll hear of the PA profession is the ability to have a flexible job and a better lifestyle, but honestly, I work more than any of the doctors at my practice. Your schedule is something you can choose based on where you work, and that's independent of whether you're a PA or doctor.

So even though I've addressed two healthcare professions here, there are so many others that you should look into! Make sure to take the time to find the job that will be the best fit for you and your personality. Other professions you may want to consider include nursing, nurse practitioner, physical therapist, nurse anesthetist, anesthesiology assistant, radiology technician, occupational therapist, or pathology assistant. If you have any other questions, don't hesitate to e-mail me at thepaplatform@gmail.com

Savanna Perry, PA-C

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