"In my life, family will always be my greatest priority. I love my patients like I love life itself, but I love my family even more than life itself." - Stephen Pasquini PA-C.
Years ago, I dreamt of being an MD.
Since I was a small child, in fact, to me, this would be the pinnacle of life. Stethoscope around my neck, working in the trenches, saving lives!
This was my childhood dream and my young adult dream, all the way through college.
Not even Organic Chemistry could stop me. I just pushed through it, head to the grindstone, determined to reach my goal.
Then one year away from finishing all my pre-med training, something happened: I met a physician assistant!
To me, life has always been more than my job. The reason I created this website is that I love art, photography, and technology. I love kids, the outdoors, and my family. I love to surf, bike, and take my son and daughter for long walks. I like to make shapes out of the clouds, go on long weekend getaways, take my wife out dancing.
I love life!
If you don't know already, being a doctor requires a TON of sacrifices.
If you are not prepared to give your life over to medicine, then I encourage you to take a long deep inward look at yourself and decide if what you want is really MD.
Before many hours working at the University of Washington Medical Center, I thought to be a doctor was fun like Michael J. Fox in the movie "Doc Hollywood" or rugged like the doctors on Mash. I wanted to be like George Clooney in the TV show ER.
This is an illusion. Being a Dr. means long hours, late nights on call, missed birthdays, missed anniversaries often second marriages. That last one is the part that is like the movies.
Wants vs. Needs
I realized that what I wanted most out of life was to help people be healthy. I love the human body, I love anatomy, and I love science.
I liked the thought of propping a young child upon the exam room table, making a funny face, and treating their ear infection.
I loved the idea of sewing up a wound, setting a fracture, being there when another human being needed someone to hold onto.
Helping someone come to terms with death while helping another come to terms with life.
I didn't want MD; I wanted all of the above. There was no other way.
Finding Balance
I have met more doctors who want to be PAs than PAs who want to be doctors.
Why? Because there is more to life than medicine. PAs have the unique opportunity to live this.
It is not about being lazy; it is not about a lack of dedication. PAs tend to be some of the most dedicated and hard-working people I know.
PA is the sweet spot! Where life and medicine meet in the middle.
I honestly believe you can be better at compassion when you are more grounded. Having a life outside of work justifies life. It makes for a happy person, which translates to better patient care.
After quite a bit of soul-searching, I realized that I never really needed to be a doctor, but I wanted to feel like one.
If you are on this journey to being a healthcare provider, know that life exists beyond MD. It is a beautiful life, and it has fulfilled every single one of my dreams of being an excellent health care provider.
And every time I prop a small child up on the exam room table and write the script to make their ear feel better, I smile. Then I go home in the evening and give my kids and my wife a big hug and a kiss.
In my life family will always be my highest priority. I love my patients like I love life itself, but I love my family even more than life itself. Click To TweetI don't think I could have found this balance as an MD, and I thank my lucky stars that life, or God or whatever directed me to UMDNJ, to PA School, to the job of my dreams.
Being a PA is truly where life and medicine have found the perfect balance. I hope you, too, will give the physician assistant profession consideration as you go about life and pursue a rewarding career in the field of medicine.
Warmly,
Stephen Pasquini PA-C
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Often the decision between PA and MD is considered a difficult one, but should it be? Click Here.
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Just came upon your website and I think it’s fantastic! Thank you for sharing and posting such great insight into your thoughts and profession! I am also at the MD vs. PA crossroad and reading through your website as I have with others just reassures my decision to go with P.A. Lately I’ve been pondering for which career I would be more satisfied with and I’m glad you touch on all the points all of us (students) wonder about. This really does help so thank you!
Thanks for your kind words Oriana,
I was once there myself so I understand completely. It gives me so much joy to share my own experiences and my love of the PA profession. Prior to attending PA school it seemed that the decision between MD and PA was such a difficult one. Now, 10 years later, as you can see from the blog, I am pretty confident I made the right choice. Is it for everybody? Certainly not, but I think you have to ask yourself 2 pertinent questions:
1. “Why do I want to go into medicine?”
2. “How do I want to spend the precious time I have here on earth.”
I have (and still don’t) feel that most MD’s have a good life/work balance. This can be great if you are somebody who values your career above all else, but in my opinion life is just too short, and there are just too many wonderful things to experience (including our children and family). That being said, I know many a PA who still manage to get caught up in the rat race, but it is a little bit harder to do, and the maze is much less convoluted 🙂
Best of luck!
Stephen
In some respects there are less ceilings as a PA! Take specialty as an example. As a PA you can easily change specialties at any time during your career, this is much harder to do as a doctor and you will be hard pressed to find many doctors who jump ship and train for a different specialty. It takes too long and comes with a large financial burden.
Also, med school cost is a ceiling in an of itself and loans can be a big limiter to certain freedoms. Income growth is quite good as a PA and continues to get better every year. As I wrote in this article https://www.thepalife.com/pa-versus-md-money/ doctors often make less on a time for money exchange which means they have to work a lot more to make just as much as a PA or a Nurse for that matter. Leadership roles abound as a PA depending on your eagerness to seek them out and income in my opinion is more a factor of ones financial education/intelligence then their medical training. Most doctors (and many PA’s) lack any type of financial education which can come back to bite many health care providers in the rear years later. Also, you have to look inside and figure out from where you draw your joy? Is it from status? Is it from being the top of the pecking order? Or is from being part of a team and providing amazing care for your patients? I 100% have never had one ounce of regret that I chose PA over MD, and my next article will probably be titled why my kids are happy I am a Physician Assistant and not an MD!
I wish you the best on your journey, I know it is not an easy decision but you will know what is right in your heart. Just follow it and you will be happy. I have asked many doctors if they are happy with the choice they made and invariably they say yes, which means life is what you make of it and maybe either way you can’t go wrong. Especially if you always strive for balance and work hard to keep those you love and who love you ahead of work.
– Stephen
Stephen, as a non-traditional student deciding between both DO and PA schools, I would sincerely LOVE to see you write the article ” why my kids are happy I am a Physician Assistant and not an MD!”. I often debate between the two, but my wife and I are in our late 20’s and have put off having kids. Now that medical school or PA school is right around the corner, I am struggling between the two. I want to be a stellar dad. I know that being either profession you put time into what you truly care most about, so you can be a good dad either way. However, I want to maximize my ability to be a terrific father (and husband). I’d be thrilled to hear your thoughts on this, and what you’ve seen in other healthcare providers.
I was wanting to go the PA route, but then started thinking the Med School route. What worries me about the PA route is if I am putting a ceiling on myself in regards to job growth and income growth. I want to make a good amount of money and have enough time to spend with family. Do Doctors work less hours than PA’s later down the road? Or do PA’s always have better hours? Do you feel that you have set a ceiling on yourself in regards to income and leadership?
Hi, follow up question, do you get/ have you been disrespected by doctors, nurses, or patients? I’m assuming that it depends on location, but constant disrespect and insulting comments could be a major negative to the job. How would you respond to rude behavior? I’m assuming retaliating would not be the correct thing to do. Thanks.
I haven’t been disrespected by doctors nurses or patients. You are likely to come across people who are difficult to work with from time to time but this is just part of life. In healthcare everyone is a team. I have never had a patient look down on me because I was a PA. If you respect your patient and provide them with high quality care you will surely get the same in return. If a patient were to ask me to see the doctor because they don’t trust PA’s (which I have never had happen) I would be more than happy to oblige. As the saying goes “pride comes before the fall”. My goal is to see the patient get what they need from each encounter, if they felt better with a doctor then I would do my best to make sure that happened. Respect is something we earn anyway, do your best always, respect others and you will be good to go!
Best of luck!
Stephen
Hi,
Thank you for your insight. I have been struggling on what I want to do in medicine. I’m worried that if I become a PA I might think that I have settled and my ego will get in the way with a constant reminder that I am not as good as a doctor. I’m so lost on what is the right choice. Your article touches on so many good points. I hate that we are socialized to feel guilty for not wanting to work so much. You said that PA’s have more time for life, but why can’t doctors just work part time. I think I want to become a PA, but I am worried that if I have friends or family that have went father I would have some regret. Thanks.
This is great! This morning I was talking to my mom about medical school and my plans on finishing up my bachelors degree and she mentioned to me about possibly going into the PA route. I didn’t think much of it. But today I saw a friend whom just recently had a baby, and it made me think about how much I’d have to give up in order to become an MD. This post just opened my closed eyes, I can not thank you enough! I am now off to do research on PA schools in nj, ny, pa. Thank you, thank you.
Hi Kimberly,
I was a Rutgers grad (in NJ) and I can’t say enough about how wonderful the program is. And as a PA for the last 10 years I cannot say how happy I am that I made this decision. And yes, it is true, my wife would agree 🙂 I wish you the very best on your research and your journey through school and eventually into medicine!
Hello there!!
I’m a sophomore at Utah State University and I know that becoming a PA is exactly what I want to do. I know that a huge part of the application process is having significant and appropriate Health Care Experience along with the great GPA, etc. I am wondering if my current job is supplying me with sufficient experience that will look outstanding on my application. I am currently a Donor Processor at the plasma center here in Logan, UT. Basically I give 20-30 “mini-physicals” or screenings a day. This consists of collecting bloods samples (to measure total protein in plasma and hematocrit), measuring blood pressure, temperature, pulse, weight and also asking a large list of medical history questions. All of this information is then charted accordingly. So far I have about 1200 hours with the company, but by the time I graduate it will be sitting around 3000 hours. I’m just curious if this is where I need to be or if I should look other places for improve my HCE hours.
Your blog is truly a breath of fresh air! Thank you for your positiveness and willingness to help us poor college students haha
Hi Jeremiah,
You will have more than the required direct patient care experience you will need so there are no worries here. Just make sure to round out your application with some appropriate volunteer work or other work outside of your current job that is community based and people focused. As always the essay is the linchpin and it is in these paragraphs that you can bring it all together. Explain hoow your skills, work and experiences have combined to make you an excellent PA school candidate. Sounds like you are well on your way.
Stephen
Hello Stephen,
I, like many others, have been dreaming of becoming an MD since I was young. However, I am involved in a serious relationship, and also have many things that I would like to accomplish in my life—outside of the hospital. I am seeing from many other websites, and from your very informative and insightful post here, that the PA route really is something that could fulfill exactly what I want. I want to help people, practice medicine, and make a true difference in the world and in the lives of others. I keep hitting a brick wall though, Stephen. The thing that fascinates me and gets my blood really going is Surgery. I work as a PCA in the ICUs in a major hospital near me (and have worked in the health field since the day I turned 16—I am almost 21 now) and every time I get to go into the OR, or even the FLOOR that HOLDS the OR, I get a feeling that I’ve never felt before and can’t even describe no matter how hard I try. I know I want to operate, but I know ill sacrifice everything if I go the MD route and become a surgeon and work 100 hour weeks. I have read that the Surgical PA can “help” with surgeries, and some MDs even delegate and give written permission for PAs to operate on their own or do half of the surgery alongside them in the OR? I graduate from a state school in MA in 1 year with my Bachelors of Science in Nursing, and was also wondering if this will help me be more competitive for applying to PA school? Medicine is where my heart is—it never was into Nursing. And aside from the million questions and conversation topics I just brought up, how do I become a Surgical PA? I know of only a few Surgical PA programs, and they are all very far away.
Any insight into anything I said, and any comments or suggestions or experiential words would be more than appreciated.
Thank you so much,
JP
Hi JP,
There is no special pathway to becoming a surgical PA. There are surgical “residency” programs that some PA’s opt to go into after they graduate from PA school, but these are unnecessary and in my humble opinion a waste of time. My cousin is a PA in orthopedics and scrubs in right alongside the doctors, they have hired many PA’s at her practice none who have gone into a post graduated PA school residency program. So the path to surgery is the same as it would be to dermatology, family practice, Allergy etc. etc. Get your bachelors, 2-3 years of PA school, pass your boards, and degree in hand. What you decide to do afterwards is entirely up to you but requires no additional schooling. It is one reason PA is so desirable because of the ability to change specialties.
Your scope in the OR will be limited though, and it depends on where you work. When I hear you describe how the OR makes you feel it sounds cut and dry… You should be a surgeon, but I think you really have to take the time to decide what it is about the OR, is it the thought of being able to lead a team of medical providers down the path of curing and treating a living, breathing human being or is it just being in the OR. If you are OK assisting then you will be happy, because you will be in the OR and part of the team. But if you dream of making those life and death decisions and being the lead of a surgical team, then you may find PA will come short of your dreams. There are other wonderful fields such as Nurse Anesthesiologist which pays great, allows a ton of freedom and I have never met a NA who is unhappy, they seem to love their jobs. Either way it sounds like you have a real passion for medicine and I can’t wait to see what you do with your life. I don’t think I have ever heard someone speak so passionately about the OR, it was wonderful!
Thanks and sorry about the late response!
Stephen
Stephen,
This article spoke to me in such a way that almost scared me! Your words are the EXACT way I feel about medicine. I want to make the sick healthy again but I didn’t want to give up so much of myself in order to do it. I come from a long long long line of MDs and I’ve watched what can happen when stuff starts to blur. The more PAs I meet and the more articles I read, the more I see that it really is that balance point. Thank you so much for this article! Hope all is well!
Thank you Julio,
Life is a balance, and true wealth (in my opinion) is the freedom of choice. Even the choice of how we deliver medicine.
I believe almost everybody who goes into medicine usually does so with good intentions. It is sad how the burden of student loan debt is to a large degree a greater predictor of how and where we practice. I have witnessed two young doctors pass away in their 50’s who work in our hospital over the last year. They were great doctors, but they had turbulent family lives. Both were in what appeared to be impeccably good health. This begs a question, why did they die so young? I have a lot of opinions on this, none of which are probably backed by hard evidence, but it is wrapped up in what you said in your comment. Thank you so much for your comment. I hope you have a wonderful day and an excellent future career as a PA… Trust me, if you choose this path you will not be disappointed!
Stephen
I just want to say thank you! I stumbled across this post while searching the pros and cons of being a PA vs MD. You described what I want out of life perfectly. You have helped me figure it out and hopefully I’ll be going to PA school by next year. Once again, thank you for changing my life.
Mission Accomplished 🙂 Patrice, I wish you the best of luck on your journey. Drop me a line anytime you have questions, I am always here to help!
Stephen
I am a sophomore in college and just recently discovered the PA field. This article made me more determined to choose this as a profession. I have always wanted to help people and also have a life outside of work. Do you have any tips for getting into a PA program?
Right now the rate of applicants accepted to PA school is about 1 in 20 in many states. This is compared to about 1 in 5 who apply to Medical School. This is not to demoralize you but just to point out that the bar for entry is perceived to be higher. But a lot of this perception is based on a fact that many people apply thinking that PA school will require less in the form of entry requirements. People know that to apply to medical school they have to have all their ducks lined up. Many PA school applicants don’t take the process seriously enough or aim for the minimum requirements which will usually end in minimum (i.e disappointing results). My advice is to look at the minimums and aim to blow these out of the water. You do not need to hit all categories. I actually find GPA to be much less important than the types of classes you have taken, if you show a desire/aptitude to challenge yourself, if you have a caring and helping “resume” that demonstrates a desire to put the needs of others first etc. etc. Start right now this minute and find a job working in the campus health center, hospital or find a volunteer position that will get you working directly with real patients. Join the local PA chapter for your State and the AAPA. Attend the conference this year, meet some PAs and find out what we do. Take a summer job doing something amazing, work with a medical mission or find a way to serve those in need. If you do this now, you will be sooooo far ahead of the game. Push yourself by taking challenging classes and make sure your major is in line with a career in medicine. Put yourself out there, and have a lot of fun doing it! That is my advice.
– Stephen
Not a lot of people take the time to write blogs like this and respond to people like you have. Thank you for this amazing article! It has definitely helped me decided what I want to do in my future. I can tell you have a huge heart to serve!!
Thank you Natalie for the kind words, it is comments like yours that make it all worth it! I wish you the best in life and all your future endeavours.
Stephen
Stephen,
I am a high school senior struggling to decide what to do with my life. I always thought I would go the MD route but was always worried I would never have time for a “life.” This was a truly invaluable and inspirational post. I believe you may have just significantly changed my life for the better. Thank you so much.
Thank you Jenny, I wish you the best of luck on your path, I am here to offer help if you ever need it along the way.
– Stephen
Great article. You are a great inspiration to me. As a PA i am not able to give time to my family. But after reading your post I have planned vacation with my family. Thank you so much for writing.
“We were entrusted by nature with the ownership of this single thing, so fleeting and slippery that anyone who will can oust us from possession.” – Seneca, Letters from a Stoic, Letter 1 – “On Saving Time” (http://www.lettersfromastoic.net/letter-1/)
Enjoy the time with your family!
– Stephen
Thank you for this great article! I am actually preparing myself for a PA school interview and was worried about my answer the question “Why not med school?”, if it is asked. I was so scared to say, because I want to enjoy my life outside my career. I didn’t know if that would be “acceptable”. Thanks again. Helpful article.
It is a true commentary on the state of society when we feel it is unacceptable to choose a career in order to enjoy our life outside of our career. I believe it is for this reason that 80% of people statistically are dissatisfied with their jobs.
I know where you are coming from though, yet I have found that those with the most satisfying life outside of work also enjoy the most satisfying work. They go hand in hand and should be mutually exclusive. As time passes I have gained an appreciation for the true value of time, I see this in action on a daily basis while practicing medicine. I have never had a patient tell me as they were dying that they “wish they had worked more”.
Best of luck to you Jenna, may your life be full of joy and may your time be full of life!
– Stephen
Heart-pricking article! This is where I was years ago in MD-land, and my new feelings towards PA school. I would love to be mentored by you! Such wisdom!
I LOVE THIS ARTICLE ! It really puts into words my heart’s desire regarding being a PA. I am so glad I stumbled across your site. You truly have a gift not only for communication, but also for providing care, love, and guidance to patients, students, and everyone in between! If its ok with you, I’d like to be a mentee 🙂 I’m sure you have many! For now I will soak in your wisdom through the gold nuggets in this blog until I hear back from you! Many blessings!
Thank you Lina, you are too kind. My wife told me if I went to medical school she would break up with me, so it was a pretty easy decision :-). I will be happy to help you in any way possible.
This is one of the biggest reasons I want to become a PA. It is the “sweet spot” that I want to create in my life, where there can be a balance of MEDICINE and LIFE.
Yes!
Hi Stephen,
Thanks so much for that post, very inspiring! Have you found that you have hit a “glass ceiling” at all with your profession? Does the thought of medical school still loom in the back of your mind? MD vs PA is such a struggle for many of us pre-med/pre-PA students, and I am worried that going the PA route will leave me regretful in the future of not pursuing the MD.
It really depends on your goals. I personally don’t believe there is a “glass ceiling” in any profession. Especially the PA profession. Ceilings are for those who lack imagination :-). A degree as a PA gives you even more freedom than MD in some respects as you can change specialties throughout life if you so desire and in the world of family practice medicine the line between MD and PA starts to blur. The only difference in our clinic is the lack of call and hospital rounds, which I am truly thankful for. We often get more time with our patients, have better working hours, good pay and lots of job satisfaction. For me there has never been an ounce of regret.
Traveling overseas to provide medical care this year solidified this even more!
Sometimes there is an ego that gets in the way, if you can let this go completely and focus on why you want a career in medicine (i.e to help patients become healthier) then there is no question in my mind… But that is just my opinion.
Stephen
Explain what you mean by the ego getting in the way because I worry about this…
Imagine you are a climber and you have set your sights on Mt. Everest. After years of preparation, you finally get your chance. You spend months making it from Katmandu to the final step right before reaching the peak. Then you get the news that a horrible storm is coming in and if you don’t evacuate you may face a certain death. You hear the news and you decide you will wait and see instead of descending down with the rest of your group. Instead of making it to the top you die on the mountain 8 hours later.
As the hiker in this story, you have failed to identify why you were on the mountain in the first place. It really had nothing to do with reaching the peak. Although it may have seemed like this. An unbalanced ego, has a way of blinding us to what truly matters.The ego is divided into two parts: 1. The primitive drives of the id and 2 The demands of the social and physical environment.
Look closely at your life, separate the primitive drive for what we consider to be “respect” and/or recognition from that of our social and physical environment… i.e the demands placed on our lives, what we want for our future and our families. Why are you “climbing your mountain”? For what purpose do you ascend this slippery slope? In the analogy above the ego got in your way, you were blinded by your convictions, when all along it was the challenge of the mountain, the beauty of Nepal, the people, the adventure, the chance to be alive on a mountain, in this wild and extreme part of the world that mattered most. If you can put the primitive drives aside, then the path will always be clear, no matter which way you are walking on the path.
Stephen
Wonderful Stephen!
Thank you so much Joanne!