Top 5 Reasons NOT to Become a Physician Assistant

Here are the Top 5 Reasons NOT to Become a Physician Assistant (PA)

1. You are becoming a PA because it’s (enter your reason here) than becoming a doctor

Examples include:

It’s easier than becoming a doctor
It’s more convenient than becoming a doctor
It’s more practical than becoming a doctor
It’s my backup plan in case I don’t get into medical school

There are lots of excellent reasons to become a PA but doing so because it's easier, more practical, as a “last resort” or any of the examples listed above is certainly not one of them.

The physician assistant profession should never be your failsafe fallback plan just in case becoming a doctor doesn’t work out for you. As in: “I wanted to be a doctor, but I am choosing to become a PA because I didn’t get into medical school,” or “I did poorly on the MCAT, so I guess I’ll apply to PA school,” or “Because I’ve heard that PA school is easier.”

We don’t mind that you weigh the decision to become a PA against that of becoming a doctor because many of us who went into the PA profession also considering becoming an MD at one time or another.

But even if you were on the MD path and later changed your mind (like I did) make sure that the decision to become a PA is in line with your passion and your purpose. Use the same type of decision making you would use while choosing a life partner. There are lots of options, many of them good ones, but only one or two that truly tickle your fancy.

Admissions committees are on the lookout for insincere candidates, and they can spot them from a mile away. Be a PA because it checks all the right boxes because you WANT to be a PA NOT because you fell short of becoming a doctor.

We are not the “fall short plan” nor do you ever want the profession you choose for your life to be one.

2. You are becoming a PA because of better work-life balance or better hours

If you have spent time shadowing or working with PAs, it becomes readily apparent, very quickly that PAs put in a lot of hours!

Not to mention, many MDs are “seeing the light” and embracing the opportunity to offload some of the more undesirable aspects of their work (like weekend rounds and after hours phone calls) to their PAs who are often left shouldering more of the clinic responsibilities.

Recent research shows that most PAs spend at least two hours per week unpaid just catching up on charting. Of course, this is in addition to an already packed 40 to 50-hour workweek.

It’s true that with time, effort and the right financial situation (i.e., two incomes, a low cost of living, not much student loan debt, the avoidance of lifestyle expansion) you can structure your life in a way so that it’s possible to work part-time or at reduced hours. I know many PAs who do just that, and it’s a dream come true. But I also know PAs who exists on the opposite end of the spectrum. They are putting in long 5 or 6-day workweeks, using weekends to catch up on errands, picking up call, working nights, dropping their kids off at daycare at 7 am and picking them up at 6 pm then going to bed with a laptop and their trusty EMR.

They are burning out just trying to keep the treadmill turning.

The truth is that work-life balance is not innate to any profession, especially healthcare workers and yes, even PAs where office hours are at all hours.

So if you are becoming a PA because of its optimal work-life balance, you may be in for a big surprise.

3. You are becoming a PA because it’s more affordable

In a recent blog post titled The Top 5 Reasons People Choose to Become a PA: Put To The Test, I tested the feasibility of the fifth most common reason people choose to become a PA based on the latest AAPA survey results: The ability to pay off debt.

Unfortunately, the results were not encouraging.

Based on national 2019 averages reporting PA student loan debt of $125,000 repaid over ten years at 4.45% interest with an estimated monthly payment of around $1,292.47 - To justify the cost of PA school education you should make no less than:

$93.21 Hourly
$16,155 Monthly
$193,870 Annually

As a new graduate PA, these are hard numbers to attain unless you are willing to trample all over your purpose, passions, and highly sought after work-life balance as discussed above.

With the increasing cost of PA school tuition, combined with sky-high undergraduate education costs and current annual reimbursement rates at around $104,000 pursuing the PA profession as a cost-saving measure is not what it used to be.

4. You are becoming a PA because someone told you too (i.e., school counselor, friend, teachers, mom, dad, etc.)

I recently had lunch with a student who is on a pre-med track. As I write this, he holds a full-ride scholarship to medical school upon graduation should he choose to accept it.

He is somewhat “non-traditional” as he has two children and is in his early 30’s. For the last ten years, he has focused on providing for his children while completing his undergraduate coursework, preparing to take the MCAT and applying to medical school.

That is until his academic advisor told him that PA would be a better route.

Before this encounter with his advisor, he had never considered becoming a PA. But as he researches the PA profession, he is beginning to think that this may be a more practical route.

Naturally, he is now full of doubt and questioning his decision to become an MD.

Should he take the more efficient, more practical route and become a PA or become an MD…the path he has been treading for many years and the one he has had his heart set on since kindergarten?

Good question!

While it is true that he will have less time in school and a faster path to full time paid work as a PA student, it’s not true that by attending medical school, he will limit his flexibility and options. Medical schools have been around for a long time, and because of this many programs have developed flexible options for parents. Part-time opportunities for PA students have been phased out at many PA programs.

Residency programs are grueling, but with the right support system, can be manageable. There are many creative financing solutions.

Don’t give up on your dream of becoming a doctor because other people (including doctors) told you to do so. If you do, this is a recipe for disappointment, constant and caustic comparison, and a lifetime full of debilitating “what if’s.”

Trust me, I’ve seen it, and it’s not pretty!

5. You are becoming a PA because you are coming to the United States as a doctor from another country

I get emails every week from foreign medical doctors and other health care providers from non-US countries looking to become a PA.

Foreign physicians interested in practicing medicine as an MD in the US, need to prepare to pass the US Medical Licensing Exams, get certified by the Educational Commission for Foreign-Trained Medical Graduates, enroll in a residency program, and then take a third licensing test.

It’s a grueling path, one that as an MD you have already completed once in your home country, so it’s natural to look for alternatives, I get it.

But becoming a PA to avoid the work of medical licensing in the US is a HORRIBLE reason to choose the PA profession.

Although your prior medical training may have prepared you well for the rigors of PA school education, PA schools are on the look-out for insincerity.

You may genuinely want to use your skills to help patients here in the US, and I applaud that, we are looking for PAs from diverse backgrounds who are passionate and excited about patient care and our profession. If this is you, then we want you.

But, don’t choose the PA profession as a half-hearted attempt to avoid the process of relicensing as an MD in the US.

And whatever you do, if you do decide to go the PA route don’t complain about having to complete the necessary prerequisite coursework and required two years of PA school education to receive your PA license. These standards are in place to protect both you and your patients. ,

Do your research, make it a point to understand the PA profession fully, know what you are getting into, then decide if it is right for you.

I know several foreign MDs who are ecstatic about the idea of becoming a PA and many others who have completed the process and are rocking their PA-C, we are more than excited to have you. But if this is not you, then I would advise you look into a different profession.

- Stephen Pasquini PA-C