"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
Recommended reading:
Often the decision between PA and MD is considered a difficult one, but should it be? Click Here.
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Hey Stephen,
I really like all that is being said here. it is quite encouraging. My name is Randy, I’m 22 yrs old, I have two Bachelor’s of Science Degrees, and I received an acceptance letter for an international medical school. I will not be able to attend because the is no federal funding. I would need to get loans in which a co-signer is needed. I do not have anyone who is willing to co-sign for me and well I lost my parents at the age of 14. I am at pivotal point right now. I have to continue to work as I do not have support to sustain my living cost. I feel that anything I do takes away time from what I really want to accomplish. Do I spend time studying for the MCAT again, in hopes I get accepted into the states or do I apply for PA school? I would like to know what would be best.
Hi Randy,
Do you think you would be happy with the job of a PA? Is that what you really want to do? Or do you really want to be an MD? If you really want to be an MD and feel PA school would be “settling” I would recommend you pursue the MD route for sure. Where there is a will there is a way, and if you have the will, it may take a little more time but I believe you can achieve your lifelong dream of going to medical school. Many of the best doctors come from difficult backgrounds, it is what builds the empathy and compassion we need to understand the human condition. If you have decided MD is not what you want (like I did) then it may be time to start giving PA school a good hard look and develop a plan. They have a similar path from an academic perspective, but after you hold your PA or MD degree the jobs are quite different. If you still aren’t sure go shadow a couple of PAs and/or doctors. This will help you decide. You will know right away if PA is the right fit.
– Stephen
Hello Stephan,
Great article 🙂
Would you kindly answer my two questions:
how has the PA programme transform your future prospects and the impacts of becoming a PA have had on your life?
Halz
Hi Halz, I am not sure I completely understand your questions but I will give it my best.
Your Question: How has the PA programme transform your future prospects and the impacts of becoming a PA: If you are asking how my particular program (Rutgers) affected my job prospects and job performance. I would say that it affected my job prospects little (most hospitals and clinics have little concern of what school you graduated from) as far as my job performance, I would say it affected it greatly. Rutgers laid a wonderful foundation for me. I am a more confident and capable provider because of it.
Hope that helps, Cheers!
Stephen
Stephen,
Thank you for this. This really hit home and I’m certainly going to consider PA school. I have been trying to study for my MCAT recently and life is just getting in the way. We had a wedding to go to, the kids want to play with Daddy, and my wife wants some time too. I started to get frustrated by how little I was getting accomplished and my three year old obviously picked up on that. She came into the room when I was studying and when she left she said “Okay, Daddy. I leave you alone now”. That just about killed me and it made me realize that there is a lot more of that to come. Surely, taking the PA route won’t eliminate it all, but it certainly won’t be 8+ years like MD/DO will.
Anyway, thanks for the site.
Al
Hi Al,
These are tough decisions to make always. As we know being a doctor is a noble pursuit and I know many great doctors who are wonderful dads. But at the end of the day it is simply impossible to be everywhere and be everything for everyone. It is all about priorities. Finding a profession that has allowed me to keep my family first and still be there for my patients – well, as you know from my blog, I think it is the best of both world. I wish you the best of luck on your journey. And you are right when you say “taking the PA route won’t eliminate it all”. Nothing will eliminate it all, but there are certainly better paths than others, and in this case I think you are making a very wise decision.
Cheers,
Stephen
Nobody on their deathbed has ever said “I wish I had spent more time at the office”. – Rabbi Harold Kushner
Hi! I am currently a college freshman at Texas A&M university. Until I read your article on this website, I always went back and forth between an MD and an PA. I want to become an OBGYN and I am afraid that choosing PA over an OBGYN would not satisfy the dreams that I see for myself. After reading your article, I looked more into a PA and how they can be involved in the obstetrics department and etc. Thank you so much for creating this website! I have a lots of questions regarding to how to become a PA and what kind of daily job life I would be looking towards? I would truly appreciate it if you could reply back.
Hi Priyanka,
I am more than happy to answer any questions you may have or direct you to resources that may help guide you. Shoot me an email anytime or you can ask your questions right here in the comments section if you prefer. Also, if you are interested in OBGYN, and especially if you want to deliver babies, I would encourage you to look into Nurse Midwife. In my opinion, this is often a better option. PAs in most states (as far as I know) can not deliver babies. The role is often in the clinic or doing prenatal care. You can assist in the OR with the supervision of an OBGYN. Here is a great comparison statement made my a practicing OGYN you may find helpful. A Nurse Midwife delivered our second child and it was an amazing experience I was so impressed by her breadth of knowledge and scope of practice.
The following is by Susan White MD (an OBGYN) regarding the difference between an Obstetrician, Midwife, and Physician assistant
I hope this was helpful.
– Stephen
Stephen,
I am so glad that I found your webpage and all the information you have provided to me or anyone that visits your page is so greatly appreciated. Yo really are here to help with the success of anyone trying to decide on their future. I thank you and I have one more question to ask.I know of only 1 program that does not require a bachelors degree for the program (GRU) and I was actively pursuing that program but I noticed that you do not have a Bachelors in Health Science but Zoology. Can I obtain a bachelors in Envirnmental Scienec and still get into a program or is it specific?
This is an amazing post! I am a freshman in college and I am struggling with choosing between NP/PA and MD. I have always wanted to be a doctor but I also want to have time for a family and raise children. The speciality I wish to persue is surgery. So my question is can PA perform surgery or would I have to become an MD to do surgery?
Hi Krista, a PA can only assist in surgery. What we do in the OR is very similar to an intern/resident. In order to be the lead during the surgery you would have to become an MD. In the clinic you would see your own patients and you would perform hospital rounds post-op. But if your goal is to be the one in charge in the OR then MD is your path, otherwise I am afraid you would be disappointed.
– Stephen
Hello Stephen,
I have found your post very informative and motivational. I am currently in school and I am a single mother of two children and Medicine has been something I have been wanting to do since I was younger but of course got very distracted and life took me in another direction but the passion is still there. Much of what I am doing I am doing it alone with a little help from my family. I started thinking of going the NP route but wasn’t sure if I could endure the length of time I would be in school. Is there much of a difference between the two? Plus if I do continue on my path to a PA program what could I expect especially being a single mother?
Hi Althea,
There is a bit of a difference. For one NP and PA programs differ in their training: NP programs follow a nursing model while PA programs follow a medical model, its subtle but it is an important difference. As you probably know to become and NP you must complete your BSN in nursing (after you make it past the nursing school wait list), usually work for a while as an RN and then later return to NP school. You will choose to specialize further once in NP school: There are several options such as women’s health, family health, pediatrics or psychiatry, among others. PA can be a more direct route and we do not choose a “specialty” in school. We therefore graduate with a bit more latitude. NPs can practice solo (which PAs can’t) but NPs working solo is usually the exception rather than the rule nowadays.
The PA path is difficult as a single mother (or dad) and I would look into a part-time program. We had several mothers in my graduating class who found this to be a very good option. If you have a lot of support and a good sitter you trust then it will be a lot easier, otherwise it can be challenging, especially during clinicals.
An alternative (and by no way settling) would be to attend nursing school and plan on working as an RN for a while while your children are small. Then, once things are a bit more calm go back to school to get your NP. Nursing can be a great career for working moms (my wife is one) provides a lot of freedom with very good pay and lots of room for growth later on.
No matter what, I am a believer that if you want something bad enough it can be done. But, as a dad of two myself I understand #1 the rigors of parenthood and #2 how quickly time passes. So you want to make sure you can be there as a parent, no be so stressed out that you can no longer enjoy your children and the process of parenting, find a career you love while making a good salary to support your family. In this case the RN to NP route with the chance to delay the transition, or a part-time PA program may be your best options.
I hope this helps some. Cheers!
– Stephen
Yes Stephen it does. I am super motivated and it’s always been PA personally but as you said with 2 little ones I sm trying to be smarter without missing much of them growing. How does the part time program work?
At Rutgers, they added an extra year onto our program which broke the didactic portion into more manageable pieces. They also allowed for some increased flexibility during clinical rotations.
Hi Stephen, My daughter is interested in becoming a pa. There are programs for entry level pa programs and also accelerated programs that finish in 5 years. These programs are at colleges that are below her acedemic accomplishments. Does it matter which college you graduate from? Would prefer to have her set in a guaranteed program, but would it hinder her future job success? (She is capable of college acceptance to Duke)
It doesn’t matter to the employer what college you graduate from and it will make little to no difference in job prospects after PA School. It may matter to your daughter though. I would argue that an undergraduate experience at Duke (with exclusive rights to sit behind Coach K with the Cameron Crazies) isn’t worth trading for the world 🙂 If I could swing it, I can tell you which one I would choose :-).
Also, I am not sure how I feel about these “accelerated” programs which place students on a guaranteed PA track from the get go. This is a newer concept and from an experience standpoint I feel undergrad + real-world work experience then PA school may be a better path for all. It also offers more flexibility from a major/minor standpoint. Also, you never know, what sounds great to a high school grad may change 4 years down the road, and it would be nice to have some room to make these very important decisions.
– Stephen
Hey Stephen,
First and foremost I’d like to thank you for this awesome resource and for taking the time to reply to all these comments and concern. I truly appreciate genuine and sincere people like you who are always there to help others.
I had a question in regards to married life/expenses during PA school. I’ll be applying to a joint program this year and I have high hopes of getting accepted. Additionally, I was planning on getting engaged this summer and possibly getting married after my first year of PA school. My main concern was in regards to financially supporting my wife and myself once we are married. I’ll be living with my parents so they will be helping, but will federal loans and grants help me cover tuition AND other living expenses? As a married man, I will have the responsibility of spending on my wife to a certain degree, so will I be able to manage that with the federal loans? This will obviously be a concern for my prospective in laws, my fiancé, and myself.
I appreciate your time
Hi Mohammed,
I was in a similar situation. I was married 1 month prior to starting PA school and my wife and I moved across country to NJ. We rented a small apartment and made due with what little money we had. In fact, we were so broke when we moved across country I remember my parents helping us cover our damage deposit on the rental so we would have a place to live.
There were two things that got us through.
1. My wife was able to find work quickly and started as an RN at Robert Wood Johnson Medical center working in the Oncology Center.
2. I applied for and received a National Health Service Corps Scholarship which gave me a monthly stipend and covered my books and tuition for the final 2 years of our 3 year PA program.
Does your wife plan to work while you are in school? Have you thought about applying to a scholarship program such as the National Health Service Corps? You do not have to pay on federal loans while you are in school and many people take out extra loans to cover the cost of living. If you are living at home with your parents your cost of living will be low, so I think you will manage just fine.
As always, aim to live within your means. Neither of us had a car payment and I was able to defer my undergrad loans (about $20,000) until after I graduated. We also aren’t big spenders by any means.
I love being married and as only 1 of 3 other married students in our program I feel having my wife there by my side, supporting each other and enjoying the experience together… It was a wonderful time. We waited to have children until after I was working for several years, which also was a wonderful decision I believe.
I hope that helps some, just don’t spend too much on your wedding 🙂
Stephen
Thank you so much Stephen! I’m actually planning to apply to the RWJ (Rutgers) PA joint-program, formerly UMDNJ. I wasn’t aware of scholarship programs like the NHSC but its something I’m definitely interested in. My main concern was whether those extra loans for living expenses are available so thats great to know that they are. I’ve been an EMT for the past two years and also have shadowed two PA since last Summer so I’m hoping my application looks strong to the Admissions Committee.
Once again, thank you for your help — I’ll definitely be back!
And thanks, the wedding definitely needs to be modest 🙂
Hi, Stephen.
Like many others, I just want to commend you for your wonderful responses to so many questions, especially to the ones concerning the crossroad of choosing to either pursue the MD/DO route or the PA/NP route. I am a nursing student working on my BSN, and I, too, have wondered whether I should pursue an FNP or DO (DO is more in line with my holistic training as a nurse. Also, most DOs go into primary care, and I would be the most competitive at a DO school).
The biggest concern, for me, is whether the benefits of going to medical school (i.e., more extensive education, liberty to start my own practice) would outweigh the cons (i.e., significantly greater cost, social/family sacrifices, significant increase in amount of time spent in training before practicing, possibility of greater difficulty in BALANCING WORK/PERSONAL LIFE). I know that I want to be able to treat the whole patient, including mentally, and I want to be able to have the opportunity to build relationships with my patients. Since I thoroughly enjoy school, a part of me wants to go to medical school and give myself a chance to explore all of the different specialties at the greatest depth possible, but I know myself, and when push comes to shove I just cannot imagine myself entering into a specialty that does not involve building long-lasting rapport with patients. Since I do desire to have these long-lasting relationships, which would likely warrant me working in a clinic eventually, my question is do you think that it is justifiable to allow PAs and NPs work independently of physicians? I am trying to look at this objectively, as this would also be a part of my decision to pursue medical school. If I felt like it was a ethical duty to go to medical school so that my patients would be in the safest hands, then I might go that route.
Anyway, this is a very emotionally and politically charged subject, and it is worth noting that even though the challenge of obtaining a DO is very appealing to me, what I want most out of a career in nursing/medicine is to be able to serve my patients and serve them exceptionally well. I also want to have a balanced life, and if I could be a physician AND have a balanced life, then that would be ideal. However, I am leery of that statement, and considering that I am pretty sure that I want to do primary care, I just do not know if it would be worth it, despite my ambition.
Lastly, my wife is from Brazil, and Brazil recognizes DOs for employment, which is also a benefit of med school should I ever want to work down there. Not sure how likely that is, though… Do you know what countries employ FNPs/PAs?
Three main questions:
What do you think about my dilemma?
Do you think FNPs/PAs should be able to work independently of physicians?
Do you know which countries employ FNPs/PAs (especially Brazil and around Central/South America)?
Thank you again, my friend, for your inspiration, wisdom, and guidance.
Ethan
Hi Ethan,
Great comment! Absolutely loved your thoughtful breakdown of this common dilemma, rest assured Ethan you are not alone!
The good news is that in many states FNPs can already work independently of physicians, PAs of course cannot. In my clinic, in the state of California, an MD must be a phone call away and can “supervise” up to 6 midlevels at a time. Where I work there is rarely a practicing physician within 20 minutes of the clinic so in this sense we have a lot of autonomy and independence. In fact, months will go by where I do not see or talk to my supervising physician besides once every 30 days or so when we have our clinic meetings. He/She is always just a phone call away, which is very comforting.
Do I think PAs should be able to work independently of physicians? The answer is no, I don’t, but many PAs working in primary care especially, have a whole lot of flexibility. This will continue to be the case and laws are ever increasing our scope of practice rapidly. I know NPs and PAs who operate and own their own clinics as well as midlevels who run practices overseas.
Internationally the grey zone gets even bigger. When I practice in Haiti for example there is frighteningly little regulation surrounding scope of care with international medical groups. I cannot comment on PA practice in Brazil, but it is worth researching. I know for example Doctors Without Boarders employs NPs but will not accept PAs because International laws are not well established.
There are advantages and disadvantages to every field you mentioned. Since you are on your path to nursing I think NP is a very attractive choice. You would have the advantage of less school, the ability to practice independently if you choose and quite a bit of flexibility from a work/life balance standpoint. That being said, I know many DOs who are very happy in life and work. It really comes down to personal preference: time in school, long term goals, etc. etc. I would make sure you understand the laws in Brazil as you mentioned this could alone be the deal breaker for you as you make your decision for the long term.
Cheers,
Stephen
Hi Stephen,
I am so thankful I stumbled upon this article! So inspiring and helpful! Thank you!!!
I am currently an elementary teacher but after taking the break after my undergrad getting a bs in biology, I am ready to head into the health care field.
A couple questions: While I have all the pre-reqs required, I am in desperate need of clinical experience hours. In your experience, what kind of clinical (hands on or other i.e. scribe, etc.) is the most advantageous for an applicant gaining acceptance as well as preparation for the profession?
Question 2: Do you see a distinct advantage or disadvantage between becoming a pa vs. a np?
Hi Kate,
Question 1: From an admissions standpoint one type of experience is not necessarily better than another. The key is that the experience is hands-on and best if you can work in contact with PAs and a wide variety of healthcare practitioners.
Question 2: NPs have a theoretical chance for a bit more autonomy, although in real world practice I find PAs and NPs function about the same. PAs have more flexibility when it comes to switching between specialties. One advantage to NP is the chance to gain medical experience as a nurse prior to NP school which is a great way to get the medical experience you need, with a job that pays well, has a lot of flexibility and allows you to develop your skills. That being said most nursing programs have a long wait list. Although I have not attended NP school I feel PA school offers a bit of an advantage when it comes to life as a diagnostician. Jumping right into the medical model as a prescriber is a mindset. The nursing model is different, and I think as PAs we are very strong in this regard. But then again I am biased.
Cheers,
Stephen
Hi Stephen,
Thank you for your article! I am from the state of Washington and fingers crossed hope to work at the UW Medical center during my year off, even if that is a long shot! Currently I am a third year undergraduate student, feeling very overwhelmed with choosing between a career as a doctor or as a PA. Both options are extremely rewarding, while both possess pros and cons of their own. I have not been able to obtain any shadowing experience thus far, which has not made the decision any easier. I have reached out to several family doctors and all said no because of HIPAA. Any suggestions?
Also, I do have a couple more questions for you. How do you respond/ react to the lack of respect or lack of knowledge the public sometimes has about the PA profession? Some patients might ask to see a doctor instead of a PA and some might ask why a PA didn’t just become a doctor. I would also love the opportunity to travel if I can and am considering joining the military in order to pay for school. With that being said however, the PA profession is fairly new (its been around since the 60’s or so) and may not be recognized in every country. I read an article that NP’s are the only “mid-level” type of physician able to participate in programs such as Doctors without Borders. Is it true that there are there traveling limitations? Hope to hear from you soon!
Savannah
Hi Savannah,
I have never felt a lack of respect, it is simply a matter of building a trusting relationship with our patients. I must admit, a couple of months ago I had to have a shave biopsy of a lesion on my nose, when I arrived at the dermatology clinic I found out they had scheduled me with the PA. I am ashamed to admit that my first thought was one of disappointment. It is not that I was seeing the PA but I was wondering how long the PA had worked at the clinic and how skilled they were at this procedure. I think this is a perfectly normal response and it is one that all our patients have from time to time. The key is to be respectful of patients fears and anxieties surrounding their health and address them appropriately. This is not specific just to PAs but to all medical professionals. If a patient were to ask to see the doctor I would happily oblige if I could, if not I would be happy to schedule them an appointment. Once you wow them with your professionalism and clinical knowledge they will be asking to see you instead of the doctor and the doctors never take that personally so whey should we? When people ask me when I am going to become a doctor I look at them like they have lost their minds and usually explain all the reasons I chose to be a PA and how happy I am with my profession. As far as travel, it is true, Doctors Without Boarders will not accept PAs but as PAs we can work all over the world as part of global health teams and I have even met PAs who have opened practices to serve the underserved in places like Haiti. We can legally practice in England, Australia and several other countries and there are even opportunities to teach in countries such as South Africa where they are starting Physician Associate programs. The only limits we have are those we place on ourselves and it will be our job to push the boundaries and open doors that are currently swinging open for PAs who want to make a positive difference in the world.
I hope this helps and I wish you the best of luck! Drop me a line anytime…
– Stephen
Hi Stephen!
I really appreciate your reply and the insight you provided! I have been wrestling with the decision between M.D. and P.A. for awhile now and unfortunately, I still am. I am hoping to get shadowing experience to gain additional perspective, just having a tough time finding finding Physicians/ PA’s who are willing to let me shadow. I have asked around, and several have had to decline due to HIPAA. Any suggestions?
The information you provided about traveling and global work is comforting as I was able to find very little about opportunities for PA’s to work abroad. It appears that several countries are just now beginning to do “trial runs” with the PA education system but don’t necessarily have the right amount of jobs to meet the needs of those aspiring to be one. Nevertheless, I remain hopeful and will look into the information you provided!
I seriously have so many questions I could ask you because there truly is so much I would like to know! One question I have is how well do you think health care jobs are delegated? Another way to ask that would be do you feel like the tasks fulfilled by doctors, PA’s, nurses, and NP’s are well balanced? Are there any jobs or tasks that you wish you could do, but are out of reach due to your scope of practice? In addition, how does the PA fit in with the other health care roles? NP’s are the leaders of nurses and doctors of PAs, nurses, and NP’s, but where does the PA fit in? Do they have any sort of leadership role or is it mostly just collaborative?
I hope all of those questions made sense, look forward to hearing back again! Thank you for taking the time to read my message and reply!
how did you become one. Like the process of becoming one
Hi Jose, it depends on where you are in the process. I have started a series on the “5 steps to PA school” this may be a good place to start.
Cheers,
Stephen
Hey Stephen,
First I’d like to say this a really inspirational article, and the fact that you are so helpful and replying to the comments after two years clearly shows your passion. I am a sophomore currently in Chemical Engineering, and have been soul searching about what to do with my life as I am not very passionate about engineering, but I am about the biomedical field. I stumbled upon the idea of PA a few days ago, and have been researching it meticulously. I was just wondering if you had some basic tips for how to spend my time wisely and most efficiently get into a PA program, and that sort of thing.
Hi Carson,
Like everything in life getting into PA school is about knowing where you want to go and drawing the roadmap to get there. I started a series on “the 5 steps to PA school” and this is a good place start https://www.thepalife.com/the-5-steps/
1. Complete the necessary prerequisite coursework
2. Obtain the required medical and hands-on patient care experience
3. Successfully prepare for and take the GRE
4. Obtain at least 3 High-Quality Letters of Recommendation
5. Complete the CASPA application and all additional supplemental materials on time.
I also really like Andrew Rodican’s book “How to get into the PA School of your choice.” It may be good to read this early on so you can start your research and formulate a plan early, this will give you a big advantage.
– Stephen
This article might have changed my life. As a second semester sophomore who knows his path lies somewhere in the medical field, this helped direct me. I’ve always wanted to be a doctor, but recently have been thinking about my future outside of medicine. I have also always wanted a family, but I don’t just want a family, I want to love my family and provide as much love and support as I possibly can. The idea of missing something important in my marriage or some important event in my future children’s lives scares the living hell out of me. I am definitely starting to change gears, and I like where I’m headed.
Hey Stephen, I came across your article and I have to tell you man you wrapped up everything I have been feeling for the past 4 years and you have truly comforted me in knowing that I am making a great decision. I am currently a College Junior and out of high school I was accepted to an Early Acceptance to Medical school program. Since I was a kid I knew I wanted to pursue a career in Medicine and I have a tremendous love for science and helping others. I have over 1,000 hours of shadowing experiences with an MD and a Nurse Practitioner, so the Early acceptance made the path to MD seem much more attainable. Throughout my experiences with both I have noticed that the MD has not had any time in the last 20 years to spend time with his family; whereas, the nurse practitioner has been able to attend all of her daughters cheer competitions and spend quality time with her family. I want to have a family, be a dad, play ball with my future sons, have time to fish, and go watch some football games with my old man. Your article really helped me as I have been questioning myself these past 3 years on whether or not I am making the right decision! THANK YOU STEPHEN!
Your welcome John! It is so rare to have over 1,000 hours of shadowing experience and you prove here just why this time is so valuable. Many people have troubles finding medical practitioners to shadow prior to submitting their PA school application. Do have any hints for other applicants who are struggling to find shadow opportunities?
– Stephen
Well for starters I live in a Medically underserved area, our nearest trauma center is 150 miles away and we have a regional hospital that air lifts all of our critical care patients. Having said that, offering to help interview patients, take patient history and take vital signs is a small price to pay in exchange for the opportunity to assist the medical team and view the health care providers assessment and diagnosis of each patient. It’s all about how you market yourself as an asset to the Doctor, Nurse practitioner, or Physician Assistant, and not as a liability. I am getting ready to start up my application for this years cycle, do you have any advice?
Hi Stephen, first of all thank you so much for this article! It truly speaks for almost all of the things that I constantly think about when deciding whether to become a PA or a Physician. On one of your previous responses you said that two questions need to be asked before making this huge decision (Why do you want to do medicine? and how do you want to spend your time?). For me, the answer to the first question has to do with my desire to help people in need (underserved populations) all while pursuing a career that would allow me to incorporate my interests in human physiology and the musculoskeletal system. While thinking about becoming a doctor, I aspired to go into a specialty such as PM&R or become a family practice doctor and do a fellowship in sports medicine. I figured a title as a doctor would not only allow me to fulfill such interests, but would also allow me to get involved in teaching later on. The more I think about it however, there are also a lot of reasons why I would consider not going to med school including the length of training, the sacrifices you have to make (primarily putting your school and responsibilities before the time spent with family), the high debt, the possibility of not landing the residency of my choice and not enjoying my job. I have been in a serious relationship for almost 8 years and I am 24 at the moment. I definitely do not want my profession taking away from what I have built for these past years, but I also want to go into something that I can truly see myself doing. When I found out about the PA profession, I was really excited to see that I could practice medicine and fulfill some of my interests while having a balanced lifestyle (only 2 years of school, much less expensive, have more time for my future family, have more time for other hobbies I enjoy), and reading this article made it all a lot more clear! So thank you again 😀
I do have a few questions that I would love for you to answer about the profession: Are there opportunities for PAs to work in a field such as PM&R or sports medicine? If so what are their limitations ( would they still be able to apply ultrasound guided injections for ex) are there any possibilities to teach with a PA degree? I truly love that PA’s have a great deal of lateral mobility which draws me in further into this profession. Are there any upward mobility options however? I would love to shift my career into teaching or a leadership role towards the end of my career. Thank you for your time in advance, I would love for you to comment on my situation.
-Andres
Hey Andres,
The truth is that the scope of PA practice is growing at an exponential rate. There are probably opportunities to work in every specialty imaginable although much of this depends on your location, previous work experience, personal desire to work within a particular field etc. etc. I have met PAs working in some of the most interesting specialties. I know where I currently work in central CA I have not seen a lot of opportunities as a PA in PM&R but I am sure they exist and quite possibly could be created by a motivated person. The procedures you can perform will be dictated by your State and your supervising physician/medical institution. There is a great amount of variability here. As you work at a place longer your scope tends to grow considerably.
Since all PAs will soon be required to hold a masters degree you will have to opportunity to teach at the University level if you would like to later. Upward mobility is hard to define exactly. The next “step up” would be MD, and there is no transitional program and likely, there never will be. An MD wanting to be a PA is required to attend 2 years of PA school and a PA wanting to become an MD (regardless of past experience) will have to go back to med school and complete residency. If you define upward mobility as taking on new tasks and responsibilities within your profession, this will be a natural consequence of time and experience as a PA.
Leadership roles abound, we have many state and national associations, maybe you will be the next president of the AAPA! You can also become a leader for causes that affect the health outcomes of those within your community or abroad. I know of two PAs who currently run clinics doing work in Haiti.
Hope this helps,
Stephen
Good evening!
Well, my name is Sarah and I just fell upon your website. I will now be following you on any social media I can find you on, I really love what you do. I normally don’t leave comments because I figure what’s the point? No one will respond, but your last response was an amazing 3 days ago so here I am!
I am nervously laying in bed thinking about PA Vs MD, like I do most nights! Well applications are opening up soon so I’m stressing even more. And I CANT DECIDE and I am SCARED lol but in a good way maybe?! (Sorry, I am currently a tiny bit emotional, this is clearly the most important thing in my life after my family)..
I want to do surgery, more than anything! And I think I would be satisfied with “assisting” and I could get past the “ego” aspect of the title and I seem to be flexible when it comes to “time” because if all goes well I’d like to land in private practice and would somewhat get my evenings off or at least spent at home or even start my own practice – yes, I’m optimistic :). BUT because I love both and see both somewhat equally is why this is so hard! Yes, PA can change their specialty but an MD makes much more money than a PA. For example, on average in my area a PA ortho makes ~ 90,000. While an MD ortho make ~ 450,000. That is a HUGE difference! I know life is not all about money but I have a big family and 4 boys (that are expensive lol) and I want to know that I made the best decision for me and my family. So any advice anyone has I am happy to listen! I just need to know if I go PA for the benefits will I always regret passing up that money and will I really be satisfied?!
Thank you!
Sarah
I would like to add one little detail.. The military is giving me a full ride through either medical program so no debt.. That’s a big deal and I thought maybe that might help with some feedback when it comes to money.
Thank you,
Sarah
Hi Sarah,
My cousin is an orthopedic PA. She works long hours and does quite a bit of call. She makes a solid 6 figure salary in the California bay area and the other day while we were out hitting some tennis balls she blew me away when she said she was researching overseas options in which to obtain her MD. As she had never mentioned this before I figured she had gone mad, but she quoted the exact same statistics you did, although in San Jose the orthopedic surgeon with whom she works is making about 600K. She is 34 and doesn’t have children, so this was not an issue for her. I think this makes a big difference and that is the only reason I mention it here.
If you are dissappointed about the money now you will surely be dissapointed as you begin to work as a surgical PA and have pretty long work hours, call, stress etc. I still believe quality of life is better as a PA, although I am starting to meet more and more PAs who seem frustrated by the economic disparity. As a family practice PA, I can tell you I have never regretted my decision, and although I never have thought about it in this way, maybe it helps that there is much less of a salary difference. In fact, if you look at the average PA salary in family practice versus a family practice doctor or pediatrician, it makes good financial sence to be a PA.
The road to surgical MD is of course much longer than surgical PA: 4 years of medical school followed by 5 years of surgical training/internship/residency. I personally cannot imagine doing this with 4 boys, something has to give. So for me this would probably be the biggest factor. How much is that time worth with your boys? PA school is hard enough and it is only 2 years.
You have a big decision to make. Being a PA rocks, and I love what I do, I wouldn’t go back to medical school if you paid me, even 450K per year! My cousin, she would probably do it in a heartbeat. I think family here is a big deciding factor and the stress/demands of med school should be weighed heavily against the benefits of the higher salary if this is the only reason for attending medical school.
My father-in-law is career military, so I do believe that doing this as part of a military family will definately have its benefits no matter what you decide.
Stephen
Hi Stephen!
I am currently in a junior college and researching different professions to pursue. I would love to one day work in the medical field and be able to support myself while still living life and pursuing my hobbies. I have been looking into becoming a PA for a while now and when I read your article I just fell in love! This sounds like the perfect path for me. I am curious what you decided to major in to pursue your passion before med school?
Thank you so much!
Amber 🙂
Hi Amber, PA is truly a wonderful profession! But remember, like all things, your success in pursuing career in combination with hobbies has as much to do with your career choice as how you arrange your priorities.
My major was in Zoology, you can read a bit more about why I chose this major here in a recent post: https://www.thepalife.com/prerequisites
The truth is though it doesn’t matter so much what you major in as long as you complete the necessary prerequisites. I chose Zoology because I was able to focus more on anatomy and physiology as well as cellular and social biology which I really liked.
Stephen