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You are here: Home / PA vs MD / MD Versus PA Showdown Round 1 – Show Me The Money!

MD Versus PA Showdown Round 1 – Show Me The Money!

July 13, 2026 By Stephen Pasquini PA-C 121 Comments

Show me the money

Updated July 2026 with the latest available national data on salaries, student debt, work hours, student loans, and taxes.

Before you read this post, I want you to take a quick survey.

What Do You Think?

Physician Assistant vs. Physician: Show Me the Money

Often, the decision between PA and physician is considered difficult—but should it be?

This was the first in a series of posts designed to help answer the age-old PA-versus-physician question. And because one of the most common searches after “physician assistant” is “salary,” I thought I would begin by addressing the elephant in the room and showing you the numbers.

Annual salary numbers by themselves are nearly useless. They do not account for the hidden variables: time spent in training, education debt, residency, taxes, career length, and hours worked each week.

So this post addresses those variables with one equation and calculates a much more useful number:

True Hourly Wage

This post is heavy with numbers, so grab your glasses—and perhaps a calculator. The results remain interesting, even after bringing the original analysis into 2026.

A quick note about the math

This is an illustrative comparison, not personal tax or financial advice. To make the three careers comparable, the updated model uses the same rules for everyone:

  • May 2025 national mean wages from the U.S. Bureau of Labor Statistics—the newest BLS occupational wage data, released in May 2026
  • A married California household with two qualifying children, one income, the standard deduction, and no other income
  • 2026 federal income-tax rules, employee FICA taxes, and the latest available California tax schedule (2025)
  • A 20-year level-payment loan model using 2026–27 federal rates: 8.07% for graduate/professional debt and 6.52% for undergraduate debt
  • No loan forgiveness, income-driven repayment, refinancing, origination fees, autopay discount, investment growth, raises, inflation, or geographic pay adjustments
  • No employer retirement match, pension, health insurance, or other benefits for any of the three careers

That final point matters. The original post credited a pension to the teacher and a retirement match to the PA but not to the physician. Because benefits vary enormously by employer and state, this revision excludes them from every calculation.

The tax calculation is also a standardized snapshot, not a literal lifetime tax forecast. It holds the married-with-two-children household constant across each career so the occupations can be compared under identical rules; real tax rates, filing status, deductions, and qualifying dependents change over time.

2026 model input Internal medicine physician PA High school teacher
Annual gross wage $267,200 $141,280 $76,320
Estimated annual income after modeled taxes $199,126 $117,549 $70,015
Education-debt principal used $215,000 $112,500 $29,560
Modeled lifetime loan payments $433,854 $227,016 $52,978
Weekly work hours used 56.5 40 53

Debt figures describe borrowers, not every graduate. Many people finish school with less debt—or no debt at all—and others owe considerably more.

So let’s get going.

Physician counting money

Physician (MD or DO): True Hourly Wage

Becoming a Physician Is Expensive

For the 2025–26 academic year, the average published undergraduate tuition and fees are $11,950 for an in-state student at a public four-year university and $45,000 at a private nonprofit four-year university. Once housing, food, books, transportation, and other expenses are added, the average annual student budgets rise to $30,990 and $65,470, respectively.

The sticker price is not the same as the debt. Grants, scholarships, family support, school choice, and employment all affect what a student actually borrows. Among 2023–24 bachelor’s degree recipients who borrowed, the average cumulative debt was $29,560.

Then comes medical school. The AAMC reports a median four-year cost of attendance for the class of 2026 of $297,745 at public medical schools and $408,150 at private medical schools. Those totals include more than tuition, but they are still sobering.

Fortunately, the average student does not borrow the full cost of attendance. According to the AAMC, 70% of the medical school class of 2025 graduated with education debt. Among those indebted graduates, the median education debt—including premedical debt—was $215,000.

Service scholarships, loan-repayment programs, and programs such as Public Service Loan Forgiveness can radically change the outcome for an individual physician. But they are not universal, so they are not included in the central calculation below.

The federal student-loan interest deduction is also too limited to rescue the economics. It remains capped at $2,500 and is subject to income phaseouts. More importantly, a tax deduction reduces taxable income; it does not reimburse the borrower dollar for dollar. To keep this comparison clean, the model does not include the deduction for any profession.

What Does $215,000 of Debt Cost?

The fixed rate on new federal graduate and professional Direct Unsubsidized Loans first disbursed from July 1, 2026, through June 30, 2027, is 8.07%. At that rate, repaying $215,000 with equal payments over 20 years would require about $1,808 per month and approximately $433,854 in total payments.

That is an illustration, not a prediction. Actual medical graduates commonly have loans issued in several years at several rates, and their repayment paths may include residency-era income-based payments, interest subsidies, forgiveness, refinancing, or accelerated repayment.

Federal graduate lending also changed on July 1, 2026. Grad PLUS borrowing ended for most new graduate and professional students, with transition exceptions for certain continuing borrowers, and new federal borrowing limits took effect. That change may push some future students toward institutional or private financing, so the economics of medical and PA education deserve even closer attention going forward.

Physician Income, Taxes, Hours, and Training

The latest BLS occupational wage release places the May 2025 national mean annual wage for general internal medicine physicians at $267,200.

Under the household and tax assumptions described above, that becomes an estimated $199,126 after federal income tax, California income tax, Social Security tax, and Medicare tax. This is not a paycheck estimate for every physician; it is one standardized tax case used for all three careers.

Internal medicine requires a three-year residency. The AAMC’s projected 2025 first-year resident stipend was $67,400. For simplicity, this model holds that stipend constant for all three years. After modeled payroll and income taxes, the resident earns approximately $62,244 per year, or $186,732 over three years.

The original article estimated that an internal medicine physician spends about 34,000 hours training after high school, including college, medical school, and residency. There is no single nationally standardized “training hours” figure, so that estimate is retained for continuity.

In the AMA’s 2024 data, internal medicine physicians reported 56.5 hours per week on work-related activities. We will continue to assume 48 working weeks per year.

If our hypothetical physician finishes residency at age 29 and retires at age 65, that creates a 36-year attending career.

Let’s Run the Numbers

True Hourly Wage for an Internal Medicine Physician

[($199,126 × 36) + $186,732 − $433,854] ÷ [(56.5 × 48 × 36) + 34,000]

$52.58 per hour

And Now the Moment You Have All Been Waiting For...

Clinician and money

Physician Assistant/Associate: True Hourly Wage

The latest BLS occupational wage data place the May 2025 national mean annual wage for PAs at $141,280. That number is reassuringly close to AAPA’s newer profession-specific finding: the 2026 AAPA Salary Report found median PA compensation of $140,000 in 2025.

Under the same household and tax assumptions, the BLS wage becomes an estimated $117,549 after modeled federal, California, and employee payroll taxes.

PAs are educated at the master’s level. Most PA programs are approximately 27 months and include more than 2,000 hours of clinical rotations. Many programs also require or strongly prefer hands-on healthcare experience before admission, although the amount varies by program.

The original article estimated about 12,400 total training hours after high school for a PA, including a bachelor’s degree, pre-PA patient-care experience, didactic education, and clinical rotations. Again, no single official national “total training hours” figure exists, so the estimate remains in the model for continuity.

The latest PAEA student-debt report is Student Report 6, published in January 2025 from the association’s 2022 matriculating and end-of-program surveys. It found that 83.0% of responding graduating PA students had borrowed for graduate PA education. The report publishes debt ranges rather than one exact median: the midpoint graduate borrower fell in the $100,000–$124,999 range.

For the calculation, I use $112,500, the rounded midpoint of that median range. This is a modeling estimate, not a PAEA-reported exact median. The same report found that 47.4% of responding graduates also had outstanding pre-PA education debt, with the midpoint borrower in the $25,000–$49,999 range. It would be misleading to add that earlier debt to every PA, so pre-PA debt is not added to the central model.

At 8.07% over 20 years, repaying $112,500 requires about $946 per month and $227,016 in total payments.

NCCPA data place the typical PA workweek near 40 hours; AAPA also reported a 40-hour median in several PA specialties in 2025. We will use 40 hours per week and 48 working weeks per year.

If our hypothetical PA finishes school at age 27 and retires at age 65, that creates a 38-year career.

Let’s Run the Numbers

True Hourly Wage for a PA

[($117,549 × 38) − $227,016] ÷ [(40 × 48 × 38) + 12,400]

$49.67 per hour

And Just for Fun—Because Both of My Parents Are Teachers

Teacher discussing money

High School Teacher: True Hourly Wage

The latest BLS occupational wage data place the May 2025 national mean annual wage for secondary school teachers, excluding special and career/technical education, at $76,320.

Under the same household and tax assumptions, that becomes an estimated $70,015 after modeled federal, California, and employee payroll taxes.

Teachers spend about 6,400 hours training after high school in the original model—the estimated classroom and study time required for a bachelor’s degree. State licensing requirements vary, and many teachers later earn graduate degrees, so an individual teacher’s training time and debt can be higher.

Among 2023–24 bachelor’s degree recipients who borrowed, the average cumulative education debt was $29,560. At the 2026–27 undergraduate federal loan rate of 6.52%, paying that balance over 20 years would require approximately $221 per month and $52,978 in total payments.

The original version assumed teachers worked only 40 hours per week for 38 weeks. That excluded too much real labor. BLS notes that teachers commonly spend evenings and weekends grading and preparing lessons, and RAND’s 2024 State of the American Teacher survey found that teachers reported an average of 53 total work hours per week, even though their contracts averaged 38 hours.

We will therefore use 53 hours per week for 40 weeks per year. If a teacher finishes college at 22 and retires at 65, that creates a 43-year career.

Many public-school teachers participate in defined-benefit pension systems, but benefit formulas, vesting, employee contributions, Social Security coverage, retirement age, and cost-of-living adjustments vary widely. Rather than invent one national pension, the model excludes retirement benefits for the teacher—just as it excludes them for the PA and physician.

Let’s Run the Numbers

True Hourly Wage for a High School Teacher

[($70,015 × 43) − $52,978] ÷ [(53 × 40 × 43) + 6,400]

$30.32 per hour

For the Love of Money

Career Gross annual wage Modeled after-tax income True hourly wage
Internal medicine physician $267,200 $199,126 $52.58
PA $141,280 $117,549 $49.67
High school teacher $76,320 $70,015 $30.32

After accounting for estimated training time, borrower debt, years worked, work hours, residency income, and taxes, the adjusted net hourly wage in this model is $52.58 for an internal medicine physician, $49.67 for a PA, and $30.32 for a high school teacher.

The physician’s annual gross wage is about 1.89 times the PA wage, but the physician’s true hourly wage is only about 1.06 times the PA true hourly wage in this model. The extra years of training, residency pay, higher debt, and longer workweek erase much of the apparent salary gap.

PA vs. Physician Round 1 still goes to the physician—but by an extremely narrow margin.

That conclusion is not universal. A physician in a higher-paying specialty, a PA with a large bonus, a teacher with an excellent pension, a graduate with no debt, or a borrower who receives forgiveness could produce a very different result. Career satisfaction, autonomy, time with family, professional risk, call schedules, geographic flexibility, and the work itself also matter—and none of them fits neatly into a salary equation.

But the central lesson survives the update: do not choose a career by comparing annual salaries alone. Compare the full path required to earn that salary and the life you will live while earning it.

Oh yeah, and how about that stay-at-home 35-year-old living in the basement in our poll? If anyone has time to run that calculation, post it in the comments. We may all be working way too hard!

If you liked this post, please feel free to share it.

—Stephen Pasquini, PA-C

Have You Seen the PA vs. Physician Infographic?

Pa vs physician infographic

View the PA vs. Physician Infographic


Sources and Methodology

  • U.S. Bureau of Labor Statistics: May 2025 national occupational employment and wage estimates
  • AAMC: Medical school debt and cost of attendance
  • AAMC: Resident and fellow stipends
  • PAEA Student Report 6: PA education debt
  • AAPA: PA education and clinical training
  • AAPA 2026 Salary Report highlights
  • AMA: 2024 physician work hours by specialty
  • NCCPA 2024 Statistical Profile of Board-Certified PAs by State
  • RAND: 2024 State of the American Teacher survey data
  • College Board: Trends in College Pricing 2025
  • College Board: Trends in Student Aid 2025
  • Federal Student Aid: 2026–27 Direct Loan interest rates
  • U.S. Department of Education: Federal graduate loan changes effective July 1, 2026
  • IRS: 2026 federal tax brackets and standard deduction
  • Social Security Administration: 2026 FICA rates and taxable maximum
  • California Franchise Tax Board: 2025 tax rates, deductions, and exemptions

Calculation precision: displayed annual figures are rounded to the nearest dollar, while the final hourly calculations use unrounded values. “True hourly wage” is an illustrative career-adjusted earnings measure created for this article; it is not a standard labor-economics metric.

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Reader Interactions

Comments

  1. John Frasure says

    July 27, 2026 at 7:15 am

    I do take a little umbrage with listing PA’s working a 40 hour week. I can assure you that many of us work many more hours than 40 each week.

    Reply
    • Stephen pasquiniStephen Pasquini PA-C says

      July 27, 2026 at 4:12 pm

      You make a completely fair point, and I appreciate you calling that out. A standard 40-hour work week often feels more like a baseline aspiration than a reality for many of us in clinical practice, especially when you factor in charting, continuing education, and the sheer administrative weight that follows us home.

      Thanks for keeping us grounded and speaking up about the actual day-to-day demands of our profession.

      Best,
      Stephen

      Reply
  2. Gigi says

    October 19, 2025 at 6:55 am

    What about pharmacist pay? how does it compare to PA?

    Reply
    • Stephen pasquiniStephen Pasquini PA-C says

      October 22, 2025 at 8:55 am

      That’s a great question — comparing pay between pharmacists and physician assistants (PAs) gives good perspective. Here’s a breakdown based on the most recent data:

      ⸻

      Pharmacist Income
      • The median annual wage for pharmacists in the U.S. was about $137,480 as of May 2024. 
      • Mean annual wage sits around $134,790, with hourly mean around $64.81/hr. 
      • Other sources quote average salaries for pharmacists at around $151,000/yr (≈ $73/hr) depending on practice setting, experience, and location. 
      • Keep in mind: in some settings (especially retail) pay growth has been limited and workload/stress remains high. 
      ⸻

      PA (Physician Assistant) Income
      • The median annual wage for PAs was about $133,260 in May 2024. 
      • According to the American Academy of Physician Associates (AAPA) 2025 salary report, median total compensation for full-time PAs rose to $134,000 with a median bonus of ~$7,500. 
      • Salary ranges vary significantly by specialty, region, employer type — e.g., surgical/ER PAs can make well over $150K. 

      ⸻

      How They Compare
      • On the surface, the compensation numbers for both professions are very similar, often in the ~$130K-$150K range, depending on experience, location, specialty and employer.
      • A pharmacist might have a slightly higher “average” in some datasets (especially when specialty/clinical roles are included) whereas PAs may have more variation (and upside) depending on specialty and clinical setting.
      • The non-salary factors differ too:
      • PAs typically have more direct patient care/clinical responsibility, procedural work, and wider variety in settings (ER, surgery, outpatient, etc).
      • Pharmacists’ work often centers around medication management, dispensing, sometimes clinical services — but retail settings especially can carry high stress, shift work, heavy workload.
      • Career mobility, specialties, on-call/overnight duties may differ significantly.

      ⸻

      My Take

      If you’re deciding between the two roles (or advising someone), pay alone isn’t the only factor — you’ll also want to weigh: scope of practice, day-to-day responsibilities, lifestyle (shifts, on-call), job outlook, growth opportunities, and personal interest/time to train.

      – Stephen

      Reply
  3. Erin says

    April 21, 2022 at 1:51 pm

    Hi there. I am really struggling. The only two things that I have always wanted to do are practice medicine and be a mother. I have to apply within a year, and I just can’t make a decision. I realize many female MDs work full time and are amazing mothers. I fully support that, and I am happy for them. Please understand that I am not criticizing these mothers, I just know myself and I know that once I have kids, I will not be happy working full time, at least when they are young. I would have absolutely no problem in med school. I LOVE school, so that is not an issue. I am not too worried about debt; I have a full ride for undergrad and I know that whether I go MD or PA, my salary will be high enough to pay off my debt. I am mostly just concerned about lifestyle. It is important to me to be home with my family, which points me in the direction of PA school. However, I have heard that the PA field is oversaturated, and it is hard to get a job lately because the profession is becoming more popular. I have heard it is especially hard in Missouri, specifically St. Louis, as this region generally prefers NPs. Is this true? I am hearing so many things and would love if you could weigh in. Thank you in advance.

    Reply
    • Stephen pasquiniStephen Pasquini PA-C says

      April 26, 2022 at 2:24 pm

      Hi Erin, I can tell you have given this a tremendous amount of consideration, so I am sure you will make the best decision for your situation. As a family practice PA working in California, I am always blown away when people mention that PAs are having trouble finding jobs in various parts of the country. The healthcare shortage is profound, so I find it hard to believe that the PA profession is saturated anywhere. But is that the case in Missouri? You may know better than I! I receive recruitment letters weekly from all types of specialties offering competitive salaries, relocation bonuses, and great benefits. The job market, according to the oft-quoted Bureau of Labor Statistics National Occupational Outlook Handbook, predicts a 31% increase over the next ten years. In California, we have been gaining ground on NPs even in family practice, and I notice the County of Santa Cruz, CA where I work (which has notoriously been bullish on NPs) has been hiring many PAs… I like to think it is because of our amazing track record.? As far as family is concerned, my partner and I have raised two children now, ages 12 and 14, as part of a healthcare family (my wife is an RN, and I am a PA), and I wouldn’t change it for the world. I know several MDs who I work with who have been integral in their children’s lives and raised very happy children, and I am fairly sure they would also say they wouldn’t have changed a thing. The one caveat here is choosing the right specialty. I think this applies to both the PA and the MD profession. Avoid surgical subspecialties if you want to be happy and part of your children’s precious childhoods. In my experience, the on-call hours and the constant grind can be exceedingly difficult to maintain while prioritizing your family. Maybe somebody else would like to weigh in on this, but that is my experience and I have seen many MDs (and PAs) lives upended because of it.

      Stephen

      Reply
  4. Alexis Rice says

    February 17, 2021 at 10:13 am

    I an currently a undergraduate student trying to figure out which route is best for me. I want to be able to build/maintain a family. I am trying to decide between NP, PA, or MD. My specialties will likely be between Obstetrics Gynecology (the more likely option), Pediatrics, or maybe even Dermatology. I am confused because when I look up average salaries it sometimes says that Nurse Practitioners make more than Physician Assistants and that they have more Autonomy, even though I also read that it varies by state. I want to be able to deliver babies and have independence. I like working in groups sometimes. I imagine myself actually working with the patient and being there for them. I could see myself being in states like CA, GA, FL, NC. Where would you recommend I do? I don’t want to be overworked which I heard is the case for nursing positions. But in my desired specialty there are barely any PA positions that will allow them to help birth babies. HELP!

    Reply
    • Stephen pasquiniStephen Pasquini PA-C says

      February 18, 2021 at 8:13 am

      Hi Alexis,

      Have you investigated nurse-midwifery as an option? Just want to add a bit more to your confusion :-)… Take a look into this and let me know your thoughts.

      Stephen

      Reply
  5. Miki says

    September 18, 2019 at 1:58 pm

    Stephen,
    Thank you for writing this post. It truly helped me decide to be a PA instead of a MD.
    I like to help people too, and I also want to have a life and hobbies outside of my career. It is great to read what you wrote!

    Reply
  6. Eugene C SANTILLANO says

    June 23, 2019 at 8:03 am

    Current loan interest can be consolidated under 4% (3.75 last offer I received in mail).

    Specialty matters, this calculation is for primary care specialist.

    For someone nervous about carrying debt, PA school is an easy decision….. but you need to apply and qualify. It may be easier to get in, so that is also a stress relief, but you may need to broaden WHERE you are willing to receive your training.

    Loan repayment programs are changing, most recently the CA loan repayment program for primary care doctors will help pay up to 300K in educational debt! This applies to primary care, let’s face it, specialists salaries are much higher, and they can afford to pay their loans.

    Many employers are able to offer loan repayment as additional salary benefit, so educational debt really should not be the reason to not choose Medical school.

    Time for training, location, family, and ultimately work life are all real. The is a major trend supporting PA training and the job availability is plentiful.

    The ability to find employment where you want to live is definitely favorable…. and you can change specialties as a PA because your not tied to board certified training limiting your job opportunities.

    Reply
    • Tim says

      July 28, 2019 at 3:41 pm

      Physicians comp varies greatly. PCP is at the bottom tier, then academic vs employed vs private practice as well as geographic region. For Family Medicine, your logic makes relatively good sense.
      However, add two more years residency/fellowship and the board certification and compensation skyrocket. Both starting comp and average comp are at least double. Easily in reach is over $500k plus large retirement plan opportunities. It is competitive and sacrifices are made. PA’s have much more limited upside. Read Medscape physician compensation surveys.

      Reply
  7. Cole says

    June 18, 2019 at 12:41 pm

    I am seriously considering the PA route. However, I am leaning heavily into the research aspect of the career… I want to research new ways to treat the brain. I have no initiatives for creating/maintaining a family, don’t mind dashing upwards of a 60+ workweek, and want to pour myself into the concepts of neurology, neuropathology and perhaps a touch of psychiatry. Also, employment autonomy and being the “final word” are important to me in a salient decision-making team. For these “personal” reasons, a lot of people suggest I should go MD or DO. Do you agree?

    Reply
    • Stephen pasquiniStephen Pasquini PA-C says

      June 19, 2019 at 2:26 pm

      Hi Cole, yes, I agree that you would probably be better off (and happier) pursuing your MD and going into research as you have suggested. And what better place than in the field of neuroscience!! You will never be bored!

      Stephen

      Reply
    • Eugene C SANTILLANO says

      June 23, 2019 at 7:43 am

      MD for research, maybe even MD/ PhD! Most combined PhD programs will pay your MD educational debt

      Reply
  8. Max Vinograd says

    March 17, 2019 at 7:43 pm

    Why not just “Why my wife is happy I am a Physician Assistant”? Do we need to downgrade another profession just to further validate our own?

    PA can be the perfect profession for some, but not for others. Also it turns out that no PA working today would have the ability to work without a supervising MD. We need great doctors! Future healthcare providers need to know all of their options when choosing a career path – and should be educated on it. But he/she should be making this decision on his/her own.

    Disclaimer: I am a PA and I love my job!

    Reply
  9. A. says

    February 24, 2019 at 8:42 am

    This isn’t how things work in real life. Doctors work more and make more than teachers and PAs- let’s not use numbers to fabricate reality here.

    Reply
    • Melissa says

      December 13, 2019 at 11:22 am

      I was wondering if someone was going to bring up REALITY in response to this obviously biased article. I am a college advisor and previous high school teacher, and my husband is currently pursuing medical school. We’ve done the math, and these numbers are way off because of faulty assumptions. One such huge assumption is that all doctors make and stay at around $210K/year. Not even close to true, especially when you get into different specialties. Another faulty assumption is that a doctor is going to take the maximum amount of time to pay off student debt, and that they have debt from their bachelor’s as well. Both would be wrong in most cases. The entire teacher’s salary calculations are waaaay off due to many factors, and I would know. This guy can’t possibly think that a high school teacher takes home within $3 of what a doctor makes, accounting for all the factors he is (mistakenly) taking into account. With the type of mathematical logic he’s using, I’m surprised at his education level. Doctors make way more than teachers, and much more than PAs as well. Let’s not fool ourselves. All one has to do is look at their differing socioeconomic lifestyles, net worths, and assets to know that. We could have saved him making up data to fit this narrative.

      Reply
      • Stephen pasquiniStephen Pasquini PA-C says

        December 17, 2019 at 8:26 am

        All good points Melissa and you are right…

        – “One such huge assumption is that all doctors make and stay at around $210K/year. Not even close to true, especially when you get into different specialties.” Yes, for a doctor pursuing surgical subspecialties it is common to make well over 400-600k per year.
        – “Another faulty assumption is that a doctor is going to take the maximum amount of time to pay off student debt and that they have debt from their bachelor’s as well.” Yes, if you are able to fund school without accruing debt this will create a much more favorable situation (for both the teacher and the doctor)

        In the end, all financial breakdowns and comparisons are going to depend on a multitude of factors that have nothing (or very little) to do with the cost and length of education and the average pay scale. One can become just as trapped while playing a game of lifestyle inflation and hedonic adaptation making 20 million dollars a year. Just look at so many artists who have found themselves bankrupt at a very young age! The truth is if you play your cards right and educate yourself on finance at an early age you can make decisions that will help you attain your goals whatever they are. Whether that is working in the Peace Corps as a doctor, helping inner-city youth as a teacher, becoming a college professor, or opening a business as a plumber, working on the NY stock exchange, or even retiring early to a sunny beachside in the Bahamas.

        Thanks for your comment, I am sure your students are lucky to have you as their college advisor!!

        Warmly,

        Stephen Pasquini PA-C
        http://www.smartypance.com
        http://www.thepalife.com

        Reply
        • happychineseboy says

          June 29, 2020 at 8:30 pm

          I have 2 major bones to pick with your calculations.

          1.) PAs get employer matching contributions, teachers get a pension, yet physicians get nothing? This is unlikely and unrealistic. Give the physician 3% match and this will add a cool $250k ($230k x 3% x 36 years) to the numerator.

          2.) MD training is 34,000 hours and PA training is 12,400? I am curious how you pulled 34,000 out of thin air. 6,400 for undergrad (consistent your other two career choices) and 3 x 3,000 (80 x 30 + 40 x 15 + 0 x 8) hours for residency (3 years since you are assuming the salary of a IM physician with a 4+2 schedule working 80 hours /week during IP blocks and 40 hrs/week during OP blocks plus 4 weeks for vacation and 4 weeks for “research” if pursuing a specialty but since the assumed doctor will not specialize this research time will be spent researching Netflix’s catalog of movies and shows). This leaves about 18,000 hours spent in medical school? Unlikely and terrible assumption. The first 2 years of medical school is about 4,000 hours and the last 2 years take up no more than 3,000 hours of “training” for didactic/clinical work. The denominator should really be reduced by about 10,000 hours.

          Make these realistic adjustments and MD earnings will dwarf a PA’s earnings.

          Even the least ambitious MDs will blow your average PA out of the water. I hope PAs are never allowed to work independently of MDs. Honestly a MD should have been required to sign off on this pathetic work of yours.

          Reply
          • SN2me says

            September 18, 2020 at 8:14 am

            Your mother should have been required to sign off on your ability to access the Internet. She either failed to teach you how to disagree cordially or you lack basic social skills. Grow up.

            Reply
        • Eddie says

          February 6, 2022 at 6:29 pm

          I have 500 k debt.
          I will pay 250 k in total and loans will be forgiven… this is via pslf.
          I am internal medicine.
          I made 420 k 2021 and expect to push 500 k this year.

          PA vs doctor aren’t even close for pay. Both great fields but not close.

          Reply
  10. CherrieAnn Lindsey says

    July 19, 2018 at 9:50 pm

    I read your article, and it was interesting to say the least. However, there was one small error…and because your parents are teachers you should know…that teachers rarely work fourty hours a week. I’m and English teacher in Kansas. My yearly income is 37000. I work Monday-Friday, but my day starts at 7:30 and I leave the building at 4:30 on a good day. I don’t get bathroom breaks, coffee breaks, and if a fight breaks out on my way to lunch…I don’t get my 25 minutes to snarf food. I also spend two to three hours a night at home grading, planning, and writing tests and lessons at least three days a week. I also must read and re read everything I as my students to read. I am also required to attend workshops and seminars often on the summers. Then couple in the students who I care about showing up to school sick, scared, or worse and worries come home with me. Please also remmwber I don’t get off everyday your child does. I have in-service days, parent teacher conferences, and work days. You job is critical don’t get me wrong. Your college costs are astronomical I agree. I also spend at a minimum 400.00 a year out of my own pocket for items needed in my classroom. Teachers work an average of 51 hours a week for fourty weeks. That translates into 39.2 hours a week for 52 weeks. Then you get you hourly wage of 15.45 per hour and I didn’t calculate for my student debt. I’ve paid 150.00 a month for the past 13 years and have 33k left to go and…I didn’t subtract my out of pocket expenses from my salary. Just saying I’m not a mathematician but your numbers might be off. Show me a teacher who works only 40 hours and only works 38 weeks a year.

    Reply
  11. SK says

    May 10, 2018 at 8:44 pm

    I want to thank you for sharing this. I am a second year college student majoring in biology and I frequently go back and forth between whether I want to go to PA school or Med school next. As a girl I tend to think a lot about the family aspect, as I wish to have all my kids before the age of 35, and be able to be a mother who is able to be around a lot as my kids grow up. This just made me about 90% sure that I want to be a PA (which is the most sure I’ve ever been). Thank you again 🙂

    Reply
    • Stephen pasquiniStephen Pasquini PA-C says

      May 10, 2018 at 10:08 pm

      Hi, SK, I am glad I was able to nudge you in the right direction! I am pretty biased, but in today’s medical climate, I think it’s safe to say that you’re making the right decision. Let me know if you ever have any questions.

      Stephen

      Reply
  12. David Garrell says

    May 8, 2018 at 12:02 pm

    I was fortunate enough to have medical school payed by my parents so I earn tons more. My father was a physician so he could afford it in the old days. My son is going to go to Med School in 2018 and I can afford to pay his entire tuition. Doctors are often a family trade just like fireman, so keep it in the family or forget it from a monitary stand point

    Reply
    • Stephen pasquiniStephen Pasquini PA-C says

      May 8, 2018 at 4:44 pm

      Good advice David, I am sure a vast majority of those who want to be doctors are not doing it for the money, nor should they. It is good to have that validated.

      Stephen

      Reply
  13. Peter Terry MD says

    July 16, 2017 at 9:05 am

    Thank you for this fascinating and insightful analysis. many people both MD and PA are not aware of the actual return on investment of their time, money, emotional strength, health etc required in training and work. either over or underestimating it.

    I request that you analyze the cost/revenue provided by the MD and PA training career track much as you have done, but with the following aim: to arrive at a number for the future value which results from each track. that is, viewing each track purely as an investment. I would be interested in seeing a future value at the time of say 10 years into post training practice, and at retirement age. thus answering the question, if you undertake this track, what value will be created at the 10th year of practice and at retirement. feel free to ignore taxes and inflation.

    my son is interested in ortho and I want him to realize the actual cost so as to make an informed decision.

    Reply
    • Will @ Financing Medicine says

      September 21, 2017 at 12:41 pm

      Interesting take on income from an hourly perspective! That’s crazy that the hourly difference is so narrow!

      Also, Dr. Terry, I’ve actually done exactly what you asked for except for a family practice doctor. (Your ortho son would be better off financially than the family practice doc.) I used some info on PA’s on this website to do it.

      I compared the salary at every age for a family practice doctor vs a PA after taking into account taxes, debt payments, and investing for retirement. I even did 2 scenarios: a financially conscious PA/doc and a not financially conscious PA/doc.

      I did this because I never really knew if a PA or family practice doctor was better off financially.

      Check it out if you’re still curious https://financingmedicine.com/2017/08/22/pa-vs-family-practice-doctor-financial-perspective/

      Reply
    • Stephen pasquiniStephen Pasquini PA-C says

      September 22, 2017 at 7:44 am

      Hi, Terry,

      Orthopedics is much more “profitable” than general practitioners. In fact, I know some orthopedic MDs who make well over 500-600K per year. Of course, time and quality of life is a big factor here as well. Specialty orthopedic PAs can make around 125k-150k per year. If an MD works for an organization the numbers are lower but probably still in the 200-300k and you don’t have all the stress of running a practice. I also think Osteopathy is an interesting choice especially for people interested in orthopedics.

      Stephen

      Reply
  14. JD says

    July 2, 2017 at 12:21 am

    After reading all this I’m kind of glad I did Engineering.
    Cost of bachelors in Aerospace Engineering – $6000 (Loan I took out to go summer school. Rest of tuition was paid by scholarship and grant)
    I have been working for 5 years now and my salary now is -$92,000

    Then again not everyone goes to become a doctor for the money. They want to help people so it’s about personal preference and satisfaction at end.

    Reply
    • Stephen pasquiniStephen Pasquini PA-C says

      September 22, 2017 at 7:46 am

      I agree completely, although I know a doctor who has both his engineering degree and is an ortho spine surgeon, so I guess there is some overlap here 🙂

      Reply
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Really great service, definitely worth the money! I am very pleased with the amount of work that went into editing my paper and giving reasons as to why sentences or paragraphs were changed around. Carly did an amazing job!
Christina, Pre-PA
Sue Edmondson was VERY thorough in her editing of my essay, as well as the promptness of her responses to me. She not only took the time to edit the grammar of my essay but helped me remove a large portion of it to focus on the important aspects of it and draw in more details. Overall, a fantastic service!
Megan Hunstad, Pre-PA
My editor knew exactly what kind of edits I was looking for and addressed all of my questions/concerns I had about my essay. I will definitely be recommending this service to my club members and friends.
Stephanie, Pre-PA
Your service was able to help me figure out exactly what I needed to include, what did not belong and helped me display my experiences the best way possible to form a great essay. Carly was able to help me create my best essay by just editing the order and grammar without changing much of any of my written work. I am very happy with how my essay turned out. Definitely worth the money, thank you for all your help!
Nicolas, Pre-PA
Even at the busiest time of the year for applications, they got me my edit in a matter of days. They did a great job with grammar, punctuation and suggestions. I am very satisfied with the draft I got back from Sue.
Andrew, Pre-PA
Lisa Tepper reviewed my personal statement and her edits were incredibly helpful. By asking me many specific questions and responding to my answers, she helped me add much-needed context to my personal stories that I didn’t even realize was missing. And she made a few subtle suggestions in my conclusion that really tied the essay altogether. I am very pleased with how my essay turned out and it is such a relief to turn in a statement that I am proud of.Thank you so much.
Kaitlin Emmerling, Pre-PA
I was extremely stressed out about writing my personal statement, and finally decided to search the internet for advice and assistance. I came across the personal statement editing service on the PA Life, and decided to give it a try. I received a response within a day, and my stress was instantly relieved. I worked personally with Duke to edit my statement, and he is a phenomenal writer. He didn’t change the content of my statement, but rather helped me tell my story in a way that is much more desirable! I cannot recommend this service enough to others seeking help on their personal statement. Duke was friendly, sincere, and definitely experienced! I felt 100% confident in his editing abilities, and we worked together the entire time so that we were both pleased with the results! Thanks again, Duke, for all of your help!
Chelsie W. Pre-PA
I wanted to let you know I’ve been accepted into FSU!!!! I got the call Friday!!! I’m thrilled and I owe a lot of it to you! Thank you so much for your help and support along this journey! I could have not done it without you!
Shayna, PA-S
I wanted to send you a quick life update and another BIG thank you! I received my acceptance at the University of Utah’s PA Program on Monday and couldn’t be happier. Thank you for all your help with my essay and interview prep. Both of these services that you provided were so helpful in my success. I will highly recommend you to any future PA student.
Lily, Pre-PA
Deanna was so amazing! She was really thorough and strengthened my essay in one edit! I feel so confident submitting my essay and I have high hopes for interviews! Thank you for providing these services to those of us with stories that need help being told. I would definitely recommend this service to everyone who wants to apply to PA school!
Valeria, Pre-PA
I want to let you know that I got accepted into Misericordia University PA program starting the Summer of 2021. So far, I have had two interviews, one rejection and one acceptance. I have two more interviews coming up, and other schools are still reviewing applications. You have been a huge part of my application process, and I just want to appreciate your time and efforts you put in during my application. Thank you, and God bless
Jani, PA-S
I am amazed by what Deanna was able to do in helping me get my supplemental essays in shape. I had hit a serious roadblock and she was able, and in an incredibly quick manner, help me remove those blocks. I am very grateful!
Lily, Pre-PA
I had an overall great experience working with Duke. He was open to my suggestions and provided great feedback on my essay. So far I haven’t gotten any interviews yet, but it is still early in the process. I will keep you updated when I get interviews. Steve
Steve Koehler, PA-S
You helped me revise my personal statement for PA school admissions earlier this year, and I wanted to let you know how much you helped me. I got eight interviews and five admissions this cycle! I’ll be attending Pacific University this May. Multiple interviewers commented on how much they liked my personal statement. They described it as “eloquent” and “genuine.” I cannot thank you enough for your help earlier this year; I feel that it was a big part of my success this cycle.
Monica Harris, PA-S
Susan did a fantastic job editing my essay! She guided me and gave me suggestions for strengthening certain sections and equally took out weak parts. After I followed her recommendations, I really felt like I had an essay where every sentence mattered and reflected who I was. Thank you so much Susan for your help. I feel that I have a stronger essay because of your honest feedback and your help!
Amanda Pre-PA
I am so happy I used your service. It really took all of my frustrations and anxiety about my personal statement away. I am really happy with the final product. While Maura did a great job with editing my grammar and making my essay sound better overall in my first edit, Sue did an amazing job turning my essay into a story that flows in my final edit.
Marissa Pre-PA
I received an acceptance call from the USC PA Program! I’m going to be a PA! I’m so overfilled with joy and gratitude!! All of my experiences led to this, and I can’t help but feel immense gratitude for every single person that was part of this journey. You were a huge component of this journey, and I appreciate all of your help. Thank you, thank you, thank you!!
Cintia Chávez, PA-S
Sue did a wonderful job. I know this is an extremely busy time of year as CASPA is accepting applications and Sue was great about responding to my initial submission and getting back to me. She provided thoughtful feedback and quality editing. Fingers crossed for an acceptance to PA school!
Jo Lynn, Pre-PA
I am beyond happy that I used PA Life. I was struggling to piece my ideas together, and Sarah came quickly to provide me with great feedback and edits to create a beautiful personal statement. She offered a quick response and great quality. In addition, she worked with me as I was trying to submit as soon as possible. Her flexibility, patience, and skill are greatly appreciated. I would 100% recommend The PA Life editing services to any person applying!
Sofia, Pre-PA
Carly did an absolutely amazing job editing my essays. From my personal statement to my supplementals, she was thorough and methodically made them into stronger essays. I am glad I was able to work with her. With her edits, I am more confident about the essays I am submitting. I would gladly recommend her to anyone!
Jacob, PRE-PA
It’s very clear that Deanna, my editor, put a good amount of time and thought into this. She FAR exceeded my expectations, even providing me with two different possible drafts (my original copy was 1500 characters too long). After paying for two separate editing services, I was initially disappointed to find that the first had not provided anywhere close to the level of feedback/review/editing that I had hoped for. I thought I was on my own again with my personal statement and did not have high hopes for any additional edits at the time that I’d received the review from Deanna, of thePAlife. The first service I’d used provided reviews that were neither thoughtful, in-depth, nor helpful, but Deanna’s edits were each of those! My hopes had been shot down by the first service but were immediately uplifted after I received Deanna’s edits. Her feedback was timely, thorough, thoughtful, critical, and even supportive! She provided an exceptional service, and I would highly recommend her to anyone
Cierra, Pre-PA
I was so glad that I chose to have Duke look over my essay, he turned it from long, rambling, and scattered to a much more concise, well written essay. I really feel as though it represents me well! Duke always responded quickly and I felt as though I got a lot of value for the money. Thank you!
Jennifer B. Pre-PA
Hi, I am beyond words to express how I feel, I got accepted, contingent on background check which I think is a formality. I want to say boldly that I am going to be a PA, thanks to you. You will be always blessed for the wonderful service you provide.  You were very kind and worked beyond what I thought could be offered. Thanks again!
Pavithra, Pre-PA
I just wanted to update you that I got waitlisted for Drexel but accept to Dominican University of California. I still have other interviews coming up. Thank you for your help!
Karmen Wu, Pre-PA
Beth Eakman is my hero! She literally took my writing and brought it to life!! I really feel like the essay she edited with me will get me into a PA program. Beth is an awesome editor, and I highly recommend her and The PA Life editing service!
Hapuruchi Avugara, Pre-PA
Carly was extremely prompt and helpful! She helped edit my personal statement into something that I am extremely confident applying with!
Danielle, Pre-PA
Carly from The PA Life was amazing as I knew she would be based on her bio! She touched base with me when she received my personal statement and gave me a turnaround timeframe that she stuck to. In fact, she completed it earlier than expected. I am beyond satisfied!!!! Thank you, Carly, and The PA Life!
Pamela, Pre-PA
Sue was great! She edited my essay in a short time frame and the comments and feedback were very informative. She helped link all of my main ideas and gave great advice regarding appropriate information for the essay. I highly recommend this service.
Michelle, Pre-PA
I truly appreciate the ideas and comments Deanna provided for my personal statement. Without her expertise in having an understanding of what PA programs are looking for in a personal statement, I would have gone in a completely different and possibly wrong direction. I highly recommend this service!
Victoria, Pre-PA
I worked with Duke to edit and complete my essay. It was a terrific experience that I would recommend to everyone! Duke has an amazing ability to help you move things around and change it a little, while still making it feel like 100% your own work. We talked out every change we made, and we both conceded to each other in different places. He made extra time for me when I got stressed out about the deadline, and worked with me for a while each time we sat down. I paid $199 for this service, and I think that was the best bargain I ever got! I have been invited back to submit supplemental applications to some schools, and I will keep the team updated about my interviews. Thanks Duke!!!
Carly Bransky, Pre-PA
I am so thankful that this editing service exists. The personal statement is incredibly important which is why I was so nervous about it. It took me two weeks to even get started because I was so nervous about writing the wrong thing. After Carly helped me with my essay, I am now so much more confident in it. Her edits were very thorough and showed that she had a really good understanding of what is important for a PA personal statement. Her email detailing her overall impression of my essay also showed she understood every single point I was trying to make and what kind of feeling I was trying to give to people reading my essay. This has been the most reassuring thing.
Angela, Pre-PA
My interviewer was so helpful and accommodating of my needs, and I would highly recommend The PA Life to a friend or peer. I love this company and the people who work here!
Erin Felter, Pre-PA
Your services have eased the stress and anxiety that results from guessing whether or not your essay contains the content that many PA programs are looking for. Your services were prompt and genuine. It is clear that you have the applicant’s success at heart. Thank you!
Madison Pre-PA
Sue did an amazing job editing my personal statement. She included all the aspects that I wanted in the statement and made it flow so much better. Thank You! Thank You!
Kendra Perkey, Pre-PA
I was at a point where I kept reading my essay over and over again and not knowing what to change. After Sue looked over and thoroughly edited the essay, I had a completely new focus! I knew exactly what to tweak and her service really cleared up any uncertainty I had with my essay. I’m now much more confident as I finish up my CASPA applications!
Julia Spalding, Pre-PA
My editor was amazing! She took everything I asked and did editing that was above and beyond. She was also great at communicating and taking my comments/opinions into consideration. 10/10 would recommend!
Ravee, Pre-PA
I used the personal statement editing service through The PA Life, and I worked with Sarah. She was AMAZING and made such a difference in both the quality of my personal statement and in my confidence as an applicant. That said, I’m so grateful to say I’ve been accepted into two out of the three programs I applied to and have an interview with the third on Friday of this week. I couldn’t be more excited!
Nikki, PA-S
The edit that I received from Sue was exactly what I was hoping for. She was able to tighten up my draft beyond my personal skill level and made edits that I was would have never thought to make. She has definitely made my personal statement stronger. Thank you, Sue!
Ethan, Pre-PA
Duke helped me write a great personal statement. I won’t know if I’ve been accepted to the program until Christmas/New Year’s, but I feel that it was worth every penny!
Alicia C. Pre-PA
I am so glad I did this! Sarah was absolutely amazing, and she did such a great job of helping put my words together in a way that sounded professional and made the most sense! She was a true hero and made me feel so much more confident in my personal statement!
Kalley, Pre-PA
I felt our mock interview was an absolute necessity to prepare for the Academic and Personal interviews from Yale School of Medicine PA Program Online. I felt the calibre of questions you had asked me, in addition to the coaching and post-question feedback, really helped me understand what an ideal response looks like and gave me time to reflect and prepare my responses for the formal interview just two days later. During my interviews I was asked plenty of questions I didn’t have a prepared response to (and I had combed through tons especially in the days following our mock interview!) I can say that I answered each question genuinely, authentically, and showed both interviewers the best version of myself. I didn’t stammer or lose my place, and I felt confident in my words and expressions. I don’t think I would have been as comfortable, calm, or confident without having accepted your guidance and feedback and learned from our time together. Gratitude for your words, encouragement, and support is an understatement. Thank you, Sarah! Best Regards, Jacob
Jacob, PRE-PA
Sarah from The PA Life was an incredible resource for editing my personal statement. Her edits took into account the big picture of the message of the statement and helped guide me when writing additional content my statement was lacking. Her edits and responses were both prompt and thorough, and I truly feel that she made a huge positive impact on my personal statement.
Travis, Pre-PA
Sue was very attentive to details and her comments and edits made a perfect sense. Thank you for your help!
Margaryta, Pre-PA
I wanted to share exciting news with you – I got accepted to UT Health San Antonio’s Physician Assistant program!!! I am so thankful for ALL of your work and talent that was put into my personal statement and supplemental essays. I could not have gotten through this process without you. I extend a thank you from my mother, Tammy, as well. We were so blessed to be paired with you. Your hard work and dedication to helping me as a Pre-PA student-led to success during the application process. I hope 2021 is treating you well and you have a blessed year!
Aubrey, PA-S
Sarah was super helpful and flexible in my schedule. Her editing really turned my essay around, and made me a much more confident applicant! I am so glad I utilized this service. I will keep you updated on my results for this round 🙂
Mollie, Pre-PA
My editor thoroughly went through my essay and provided exactly what I was looking for to bring my essay to the next level.
Matthew, Pre-PA
This company is THE BEST! Carly did such an awesome job of not only revising my personal statement but also explaining every step she made. It helped me understand why certain things fit better in different places and helped improve my writing. I am able to submit my applications confidently, knowing that I have a strong personal statement. I HIGHLY recommend this service!
Tiffany M, Pre-PA
Oh my gosh thank you SOO much!!! I have been so busy with school so I haven’t been able to edit my personal statement, but I want to thank you soo much for making my statement look a heck of a lot better!!! I will be editing it over my spring break since that is the only free time I have, and I most likely will do a re-edit if I can (its $35 ish right?). Anyways thank you so much again!! Sorry for the late reply but I will get back to you again during my spring break if I need a second edit, thank you so much again for all your help!! I can already see how much of a difference you’ve made! Totally worth my money!
Melat Ashagre, Pre-PA
The service provided was excellent. I really appreciate Duke taking the time and reviewing my essay multiple times and at that same time, making sure I am comfortable with the wording. Thank you for all your help!
Foram Patel, Pre-PA
This is just a great service overall, because not only is it an editing service, it is specific to the PA personal statement. Sue did a wonderful job editing my essay, and pointed out important flaws in it that I otherwise might not have noticed. Her edits highlighted the main points that I was trying to get across in a much better way than I had originally written. Overall, very satisfied with the results, and will have to keep you updated about the interviews. Thanks so much!
Sabrina L. Pre-PA
I wanted to let you know I got accepted into the PA program at Mercy College and have another interview at Pace University PA program next week. Thank you so much for guiding me through this process. I just want you to know I really appreciate the time you put into working with me.
Alex (Future PA)
The ease, frequency, and promptness of communication were some of the best aspects of this service. I found the review and revisions to be very thoughtful and explained in a way where I knew exactly how to apply them to my essay. I would 100% recommend the PA Life PS review to any applicant, and especially enjoyed working with Carly. I am hopeful my personal statement will gain the attention of PA programs I am applying to.
Charlie, Pre-PA
Really helpful! Makes me feel confident.
Qui T. Pre-PA
Beth, my editor with The PA Life, truly made my essay feel impactful and, most importantly, expressed what I have to contribute to the PA profession. The one-on-one editing session we had was the most beneficial advice I have ever received, and her ability to work with my essay and make it so powerful was incredible. She is a professor, and her teaching methods were so easy to follow and guided me through how to write such a meaningful essay. I finally feel like an immense weight has been lifted off my shoulders after having her help me with the writing process and how to make what I have written even more high impact. I am forever grateful for this service. It has provided me with Beth, the sweetest and most insightful editor ever, a woman I admire and will be an essential factor in my journey to attending PA school. I currently feel confident in my abilities to receive an interview after working with her.
Sophia, Pre-PA
Sue was extremely prompt and thoughtful in providing her comments, edits, and revisions. My essay had a good start but she helped me write it with admissions committees in mind. I will keep you updated on if I get interview invitations.
Kirsten, Pre-PA
I just wanted to send you a quick email, letting you know that I finally got accepted into PA school! I will be attending Sacred Heart University in Connecticut and will be starting this fall. I could not have made it this far without your help! This was my third time applying and during my first two cycles, I didn’t think that I needed outside help. But this time around, I decided that I needed to change my tactic and I am so freaking happy that I did. Your guidance and advice on my personal statement absolutely made a difference. I had 6 interviews and got accepted into 4! You have helped changed my life and I am forever grateful. I have several friends who will be applying this cycle so I will be referring them to you!
Christian, Pre-PA
I can not speak highly enough of Sarah. She was extremely helpful and easy to work with. I think she did an especially admirable job packaging the message I was trying to get across in my essay in a concise format that flows smoothly. Thank you again!
Ian, Pre-PA
About a year ago you helped edit my personal statement to get into PA school! I just wanted to let you know that I got interviews and was accepted to all the schools I applied to! I have decided to attend UAB in the fall! Thank you again for all your help!
Lauren Smith, PA-S

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