PA or MD?

I wrote the following blog last weekend when I was really struggling with whether I should head towards PA school or med school. I am not struggling with this like I was a week ago, but I thought it was important to post anyway.

I have really been flip flopping lately on the whole PA vs. MD question. I went into this adventure absolutely all for being a PA, but sometimes doubt slips into my mind. I have contemplated nursing as well, but I really want to both diagnose and treat, and nurses don’t get to diagnose (unless they become NPs). I originally ruled out MD because of the time that it takes to get the degree and the requisite training, the cost, and the fact that I want to have kids before I am no longer able. I wonder though if I will look back and regret my decision to not go “all the way”. I am intelligent enough and I think determined enough to make it through the school and residency, but still I worry. I am going to try and explain this, but honestly my feeling change so frequently that it is hard for me to even keep up.

The PA profession was created for former Navy corpsmen that had been serving during Vietnam and had gained substantial clinical experience in treating wounded. What they needed was the education to add to their training and experience to make them quality healthcare providers. PA school has morphed since then and you can now get in if you have great grades and have volunteered some in a hospital to get some experience working with patients. Some schools still require 1 or 2 years of actual paid hands on patient care experience. I am hoping to get a position as an ER tech where I can gain some experience because I do feel that there is a lot to be gained from actually working in healthcare prior to going back to school. I worry that the little time that I am going to be able to put into work will not really be enough and that even though I might still get into a PA school, that I will not be as good of a medical provider as if I had either more time working or had I gone to med school. I don’t even know that I could get into med school, but let’s not go there now. I want to have the knowledge base and training to be great at my job. This is how the debate has resurfaced in my head; will I be a competent medical provider if I only have volunteer experience and two years of postgraduate training?

I think a lot about having kids, and I think that the decision if and when to start a family is the main deciding factor in which path I ultimately go after. We are not ready now, that is for sure, but will we be in two years, or three, or four? Training to become a MD will take me 7 years. I do not plan to go into surgery as a MD or a PA. I would like to work in emergency medicine, so 7 years (4 med school and 3 residency). People have kids during med school and residency, those things happen, but I don’t know that I would want that kind of extra stress and pressure. Theoretically I could apply to med school this summer if I took the Organic Chem that is required. So if I get in on the first try, I will be 27 when I apply and 28 when I start school. I would be 30 when I graduated as a PA, or 32 as an MD. With the added residency of going the MD route, I would be 35 when all was said and done.

I have two more semesters to finish the pre-reqs needed for either school, Spring and Summer. This spring I planned to take Biology II, Microbiology, Statistics, and Human Development. I rearranged my schedule to see if I could fit in Organic I, and I managed to create a schedule that contains Biology II, Microbiology, Organic I, and Genetics. That is a lot of science, but I think I could do it. The problem is that one of the classes runs until 5:30 one night. I had planned on taking a CNA class in January that would be a night class from 5:30 to 9:30 M-F. The CNA class would allow me to get a job and start getting some experience which I feel is something that I need to do prior to PA school. I meant to take the class this summer while I was taking time off from classes, but I got lazy and never took it. I regret not taking it then, it would have been so much easier and I could already be working. So I could take the schedule that would allow me to think about PA vs. MD for another semester, or I could get the certification and start gaining some experience. I don’t know what to do. I need to be studying for my Lab Practical that is on Monday, but I keep getting distracted by everything else going on in my head.

I honestly don’t know what to do. I think the best thing would be to start talking to as many PAs and MDs that will talk to me about what they do, especially females. I am impatient, though, because if I decide to switch my schedule, I need to do it quickly before the classes fill up. I have my schedule set as of right now, but if I want to get into Organic, I will have to act fairly quickly.