PA or MD? Here's how I'd think about it.

This is one of the most common questions I get, and the honest answer is that it comes down to what you want your life to look like. Not which path is harder. Not which one sounds more impressive.

I brought on Dr. Ryan Gray to help me compare the two, so you're hearing it from both sides instead of just from me.

What we cover:

• Length and cost of training for each path
• Scope of practice and how much autonomy PAs really have
• Switching specialties without starting over
• Salary and lifestyle tradeoffs
• How the prerequisites and applications differ
• The questions to ask yourself before you commit either way

Resources:

Free application timeline: https://www.thepaplatform.com/services/free-application-timeline

PA Program Map: https://www.thepaplatform.com/pa-platform-map

Talk it through with me one-on-one: https://www.thepaplatform.com/services/pre-pa-counseling

Welcome to the Pre PA Club podcast.

If you want to learn how to become a physician assistant, you're in the right place.

I'm your host, Savannah Perry.

Let's get to it.

Hey, guys.

So today I'm so excited because I'm debuting the very first interview on the Pre PA Club podcast.

And.

And it is with a very special guest.

So I love listening to podcasts and the other day I stumbled upon one called the Pre Med Years.

I listened to a few episodes and I realized that it was very similar to what I do with the PA platform and with the Pre PA Club podcast.

But it's been around a lot longer and the subject matter is medical school.

So I know a ton of people have questions and have a difficult time deciding between going the PA route and going the med school route.

So I reached out to the host, Dr. Ryan Gray, and asked if he would like to come on the podcast for an interview.

So we chatted for a little bit and found out we do very similar things.

And after that we decided, why don't we just post this interview on both of our podcasts?

Because it's relevant to to pre med students who may be considering PA and PA students who may still be considering medical school.

So during this interview we talk about all of the similarities, the differences, the pros, the cons of schooling, the actual professions, what testing looks like, all kinds of things.

So we really dive deep into the differences and hopefully can help guide you in making your decision.

Ryan Gray is the founder of medicalschoolhq.net and he runs a ton of podcasts.

But the one that I found him on was the Pre Med Years.

So if you are thinking about pre med stuff, head over there and check out some of the episodes.

But for now, let's get into this interview and I think you're gonna get so much value out of this and it's going to answer a lot of questions for you.

Enjoy.

Hey, Dr. Gray, how are you doing today?

I'm doing great, Savannah.

How are you?

I'm awesome.

Please, it's Ryan.

Oh, Ryan.

Okay, well, how about you go ahead and introduce yourself to my listeners and tell them a little bit about yourself.

So my name is Ryan Gray.

Dr. Gray, as Savannah said, I am a physician by training and somehow stumbled into the pre med world, advising world, and now I don't practice anymore.

I am a full time podcaster is what I like to call myself because that sounds really cool.

I have, I have four podcasts with some more coming.

Helping pre med students get into medical school.

And then I help advise them with personal statements and interviewing and all of that fun stuff.

And then on the side, I teach a little bit at the local medical school where I'm at here in Colorado.

So that's what I do.

And what about for my audience?

Who are you?

So my name is Savannah Perry, and I'm a physician assistant.

I practice full time in dermatology.

I graduated from PA school three years ago now, and similar to you, I've gotten into kind of the coaching world on the PA side of things.

So with my website, the PA platform, I help students get into PA school, kind of help them learn the ropes and figure out what's needed and how to get there to reach their goals.

And I'm also married to an internal medicine resident, so he's a second year.

So I've kind of seen both sides of things as I was going through PA school, my husband was going through medical school.

So it's kind of an interesting perspective on my part.

Yeah.

So let's talk about that a little bit.

I think that was where we wanted to go with this kind of crossover episode is why.

Why did you choose pa?

Why did I choose physician?

What are some differences?

What are some similarities?

Because I think.

I think there.

There's a huge crossover, obviously, but then there are still a lot of differences.

And so for my audience, I always, naturally, the question always comes up, if I don't get into medical school, should I.

Should I choose being a PA as a plan B?

And my response is always, PA is different than being a physician.

It's still healthcare.

It's still patient care.

But if you want to be a physician, be a physician.

If you have shadowed PAs, and if you've shadowed NPs or those other career fields, then sure, if that's.

If that looks good to you, if you're happy with that, then great, go ahead and do that, because we obviously need PAs and NPS too.

So from your perspective, let's.

Let's talk about your journey a little bit.

Being married to a physician, going through the process together, applications together and all that.

Why did you choose the PA route over going MD or do so?

And it's actually interesting because it goes back even further because we actually started dating in high school, so we've been through undergrad together, where we went to the same school.

We were both biology majors.

So even though we were pursuing these different tracks, we took exactly the same classes.

So I really have seen it from, really the decision stage for both of us.

And I think for me, freshman Year was tough for me, in a sense of trying to decide what I wanted to do with my future.

I've always been someone who's very focused on the future and wanting a plan in place.

And so while I was trying to decide those things, I ping ponged all over the place.

I thought about pa, I thought about med school, dental school, PT school.

I.

My thoughts were going crazy.

So I did a lot of research and like you mentioned, for me it came down to shadowing and really taking the time to follow around some PAs, follow some doctors, and just see what those differences looked like on a daily basis while taking into consideration the schooling differences.

And I think that was a huge part of my decision as well, because I just couldn't see myself in school and making the commitment that medical school requires.

I wanted to be able to start my family, I wanted to be able to get out there and start working and working with patients.

And I really didn't know if I could commit to one specialty.

Not that lateral mobility is the biggest part of being a pa. And I think it's a little bit overrated because most PAs end up staying in one specialty.

But for me it just made sense.

And I really liked the teamwork aspect and even as a physician, of course you can have that aspect if you have a PA that you work with.

But for me, I liked having someone to bounce ideas off.

I liked the relationships that I was able to observe when it came to my husband's decision.

His dad is a dentist and so he went in kind of thinking, maybe I want to be a dentist.

But I think during freshman year he really felt like he wanted to be more involved in just patient care on the medical side of things.

And for him it wasn't really a decision.

He just felt like he needed to go to medical school.

I think later on he realized a little bit more what all is involved.

And even now he'll tell people, if you know you want to be a doctor, go to medical school.

If you are not sure about it, take some time to figure it out.

Look at pa if you want to be involved with healthcare, but you don't necessarily want to go through all that training because it's intense.

I know you know that as a physician, but he as a second year resident, I mean, he's on the tail end of a month of nights where he works six days a week for 12 plus hours and gets one day off.

And yeah, it's definitely been a journey to get here.

And I have to say I'm completely happy with my Decision.

At the end of the day, there are some things that I think the biggest thing for me that I could change or that I wish I had is sometimes I do feel like I missed out on that residency training.

Hearing my supervising physician talk about some of these really cool cases that she got to see in residency at an academic center, that makes me a little jealous, honestly.

I wish I had that intense training, but I have a great supervising physician who teaches me every day, and so I do feel like I get that to some degree.

We just don't necessarily see some of those really cool cases.

So let me ask you, I've heard rumors about PAs going into residencies or the PA world starting residencies or starting to introduce residencies after PA school.

Where is that in the world?

So residencies for PAs have been around for a little while now.

There's definitely more of them in more specialties coming up, so.

And they're different than medical residencies as far as physician residencies go.

For the PA residencies, it's more or less if you know there is a specific field you want to work in.

PA school is so quick and so general that for.

For something like surgery or ICU or emergency medicine, if you want that extra training, there are options now of programs, usually they're only a year of an intense residency like training program in certain areas.

There really aren't any formal ones in dermatology yet, but there are a couple popping up in things like urology and obgyn.

And to be honest, they're a little controversial because that's not exactly how the PA profession was designed.

And a lot of times you can get the same training on the job and make a higher salary coming out and then be trained in the way that your physician would prefer instead of going through that residency.

So the benefits have yet to be determined from that.

It's interesting you use the term your physician.

Yeah.

As a pain.

What percentage of the time are you working under the physician?

And what percent of the time are you actually just seeing patients, making your decisions and just doing your job as a provider?

So I would say in my role in dermatology, I see about 30 patients a day, and on a typical day, my supervising physician might see one with me.

So.

So Today I saw 30 patients, she saw one with me just to pop in really quick and make sure that we were on the same page.

And then I discussed one other case with her.

So at this point, I'm very, very autonomous and we have a very great relationship.

There's a lot of trust There, she trusts me to make decisions that are wise and that are within my scope of practice.

And she knows that if I feel uncomfortable or out of place, I'm going to come and discuss it with her.

And she's great about kind of dropping what she's doing to help me out.

And we have a really neat relationship because she does the same thing.

So it's not uncommon for her to see a patient and to come ask my opinion.

And some of that comes with the fact that she has a family.

And so I go to a lot more conferences than she does.

Sometimes I'm a little bit more aware of newer things going on.

And so we have a great working relationship in that way.

I consider her a friend, and it's really awesome.

And I don't feel limited in my role in any way right now.

I don't do a ton of surgery, but I could if I wanted to.

It's another trust thing.

And for me, I just found that it's better for my schedule and a little bit more lucrative, honestly, for me to see patients.

What, from your perspective, when you were going through training, and I know you're limited now because your husband's in residency, but every state has different rules for PAs.

Is that going to come into play in the future, deciding on where to live as a pa, of how autonomous a PA can be depending on the state?

Yeah, that is a tough thing.

What I found, for the most part, though, and this is something that the aapa, kind of the state, the National Society for pas, is working on, is making that more of a decision between the supervising physician and the PA, instead of, let's say, the state medical licensing board.

So I think I would prefer if we had to move to go to a state that is referred to as PA Friendly, where PAs are able to be a little bit more autonomous and do more.

But it's something that is just.

It's a little bit difficult.

And even where I am in Georgia, we've had a few issues with the FDA changing a drug schedule and the state legislation not catching up yet.

And so pas, who could once write certain pain medications, cannot anymore.

And that's a problem for surgical and emergency medicine PAs.

So it's a continuous battle, and I think that's something where just more awareness and more legislation will come into play.

But it hasn't really affected me to this point.

Okay, do you feel.

How do you feel about the Autonomy level of PAs as a physician?

Well, it's interesting because I never really worked with PAs, so from my personal experience, I didn't really.

Well, that's.

That's not 100% true.

So in my job, I was an Air Force flight surgeon for five years, and in my clinic, I never worked with any PAs.

I.

The air Force has special independent duty medical technicians, IDMTs that are.

Are like super EMTs, basically.

And he.

And he would see some of his own patients and act almost like a pa.

I've actually interviewed some of them who are going to PA school.

Yeah.

And it's an easy transition for them into PA school because that's the role that they're used to and how much freedom they have and how much supervision they have.

But that was my clinic.

But in the family practice clinic, the actual.

The provider in charge was a PA, and so I've worked side by side with PAs, but just not in my clinic.

Gotcha.

But it's interesting, though, from my perspective as somebody who helps people into medical school is I talk to a lot of PAs who went to PA school, liked their job for a couple years, and then realized they just, for them, they don't know enough and they want to know more.

And so it's always this balance of what are you happy with knowing, what are you happy with treating?

And is it going to gnaw at you that you're not treating the most acute things, you're not treating the most difficult patients and diseases?

So that's kind of an interesting battle.

Yeah.

I mean, I feel like, for me, that's where I'm very happy treating things like acne.

Like, I have a great.

What I would call an algorithm.

I know how to make them better, which I love seeing teenagers get better, and so I love seeing those patients.

But if a crazy rash comes in or something that's out of my league, I am perfectly happy passing that along to my supervising physician.

And I love learning about it and being involved in those cases, but I'm also okay with them being kind of over my head.

And that may change as I get further into my practice.

And I feel, even now, after three years, there are things I'm much more comfortable with now.

But, yeah, that's interesting.

And I've known some PAs as well, who have decided to go back and try to go to med school.

On the flip side of that, do you know any physicians who are unhappy with their career choice?

Oh, there's.

There's a lot of physicians that are unhappy with their career choice.

Yeah, the majority of people.

But it's.

It's interesting.

It's, I think, unhappiness with or being unfulfilled with a career choice is not very physician specific.

If you look at just the US in general, it's a cultural thing.

For some reason, everybody just isn't happy, which is unfortunate.

But that's a discussion for another podcast.

Let's talk and compare and contrast a little bit the path to getting to apply to, to PA school and to medical school.

Because I think for my audience, students who are pre med wanting to go to medical school, they think, oh, if I don't get into to medical school, then I can just all apply to PA school.

But I think it's harder than just,.

It's much more difficult than that just.

Applying to a different application service.

Talk about the process for you guys.

So for PA school it's a pretty rigorous application process and it's getting more and more competitive each year.

And, and that's what was kind of funny about while me and my husband were in college was even though he was applying to medical school, I had so many more requirements than he did.

So there are more class requirements, things like anatomy and physiology you have to take to get into PA school.

And there are some other courses, basically the biologies, the chemistries, biochemistry, microbiology, some genetics, statistics, medical terminology.

I think because PA school is so quick, they want you to have a lot of that under your belt before you get there because they're not going to go over it again.

I mean, we did do anatomy and physiology, but it was much more intense than an undergraduate level course and it was actually the same course at my program that the medical students went through.

So you have to have a lot more courses and then you have to have healthcare experience.

And I think this is also a big differentiation between medical school because med schools want you to have research, whereas that's not really important for PA school.

They honestly don't care if you have research.

They want you to have interacted with patients and they want you to know that you enjoy interacting with patients.

So whether you're a nursing assistant, an emt, a medical assistant, something along those lines.

And some of these programs are requiring a thousand, two thousand hours.

Yeah.

So for someone, I think that's the.

Biggest thing because I'll, I'll, I'll challenge you a little bit.

The research side isn't, isn't as important as most people think for medical school side, uhm, clinical experience is.

But I want, I wanted you to get to that point where you made the differentiation which is the biggest part is that most PA programs that I've seen require a certain Amount of clinical hours, and it's a lot.

Yep.

Whereas where.

And it's the same purpose for medicine.

They want you to get clinical experience.

They want to make sure that you like being around sick people and not just you.

You liked being around your sick grandma.

And so now you want to be a doctor, but you actually like taking care of somebody who's not your family member.

Yeah.

Cause that's a huge difference.

So.

Yeah.

And so for PA school, I think that's where.

Where pre med students are like, I'll just.

I'll apply to PA school.

Like, okay, you can apply in a year or two after you get enough clinical hours to satisfy their requirements.

Well, and that's where I think it goes back to the origin of the PA profession, because it was originally developed as a second career.

And this was when people were coming back, like you said, from army jobs, where they were basically acting as a PA or as a physician assistant.

And in civilian life, they didn't have a place to go.

They at that point didn't want to go to medical school, but they had all this knowledge and these skills.

And so the PA profession was developed as this secondary career.

And some programs still really want those people who are coming into this as a second career, whether they've been nurses or respiratory therapists or have some type of strong background in healthcare and are just ready for that next step with, like you said, more knowledge, more responsibility, but not ready to commit to medical school and becoming a physician.

Interesting.

So how many years for PA school?

The programs range from 24 to 36 months.

And this is where it's also a little bit different than medical school.

And I know not all medical schools are the same, but my PA program for that first.

Usually the first year is didactic, so you're in the classroom and.

And we were in class every single day from 8am to 5pm and then after that we went into clinical rotations for a year.

Whereas I was watching my husband go through medical school and he was only in class from 8am to 12pm and then had the afternoons to study.

And then they got the summers off, where we went straight through, no breaks, except for a week for Christmas and a week in between semesters.

Yeah, some med schools are getting rid of that summer break, that first summer break, typically, that you get, because a big draw is early clinical exposure.

So if they cut out that summer and just take classes, then you get earlier clinical exposure.

And so I like that summer, though.

That's the last kind of research.

Yeah, my husband did research the whole time, which was nice because he got a tiny little paycheck, but.

And I think it did help his residency applications.

So two years or three years compared to four years for medical school.

So for the medical school side, it's two years of.

Typically, the standard is two years non clinical.

Right.

So you're in the classroom, and then that prepares you for step one, or level one of the boards, which you need to pass to continue on in your training.

And then you do clinical rotations for two years before applying.

Your fourth year, you apply for residencies.

When you're.

When you're in school for pa, are there any boards that you're taking while you're in school?

Or does all that come after?

All of it's after.

So there's one national certifying exam afterwards called the pants, and.

Yeah, I know.

And so we took that at the end and it was just a very general test.

And you pass that and you're good to go.

So that was the kind of certifying side of things.

And I think those exams, the step one, step two, step three, that's such an intimidating part of medical school.

What did you feel about the competitiveness of medical school?

Did you ever feel that at all?

It's funny because my whole motto with my podcast and everything is collaboration, not competition.

Right.

So the pre med world, super cutthroat, super, super competitive.

And I'm trying to fix that.

That's my big mission in life, because I don't think it needs to be.

But once you're in medical school, there's gonna be what we call gunners, the students who are out trying to do as best as they can and cut you down in the process.

But the majority of students, I went to New York Medical College in New York, and the vast, vast majority of students are there to help you and collaborate and build a community.

So some of my best friends are med school classmates.

So I think the competitive nature while in medical school is nowhere near what it is in the pre med world.

That's good.

Yeah.

I feel like PA school was a family and we all helped each other and it was cool to have everyone's different backgrounds because in PA school, we learned a lot of things on each other, like how to do IVs and venipuncture, and it was really the EMTs in my class who taught us that.

So it was really nice to have all those different backgrounds.

And like you said, three of my best friends are from PA school and we still talk almost every day.

Yeah, from the.

From the standpoint of moving around in careers.

You had mentioned that PAs, even though you have some lateral mobility in terms of specialty, you said most just choose a specialty and stay there.

Do you know any stats on that?

I don't.

I don't think there are really good ones out there.

From what I've seen and just from talking to pas, I think it's usually within the first few years of graduation that people tend to move around, just trying to figure out where they belong, figure out what they're interested in.

For me, coming out of school, I knew that I wanted to do either dermatology or surgery, so I was very fortunate to find an awesome job, and it's worked out wonderfully.

I hope I never have to give that up.

But the nice thing is I do know that if we had to move for fellowship or for a job, for my husband's job, I could find a job.

And because of my dermatology experience, it would make me, I don't know, a hot commodity for a family practice office or an urgent care in the areas that they struggle, because I do have that background.

So it's an interesting ability to move around.

But I would say that most PAs, once they find somewhere they like and are happy, they do tend to stay there.

Yeah.

And I think that's a big, a big thing to highlight for your audience.

For potential pre PA students that are listening, it's kind of the same in medicine as well.

Yes, you need to apply for residencies, but you can do internal medicine, and then you explore all of the internal medicine fields.

Endocrinology, pulmonology, cardiology, gi, the rheumatology, the list goes on and on for all of those different subspecialties.

Or you could choose general surgery and figure out what you like in the surgical fields before going on and specializing in.

In a surgical specialty as well.

So I think if, if you're a student listening to this, going, I want to be a PA because I want to be able to, to move around and choose different specialties.

Well, in reality, that doesn't really happen, but as, as a medical student as well, and then going to residencies, you have that same lateral mobility.

Once you're in residency doing your fellowship training, that's where you get the different stuff to explore.

Yeah, I agree with that.

And that's a stereotype that I'm kind of trying to break as well.

The whole, I want to be a PA because of lateral mobility, because I think if you want to be a pa, you should want to do it for the everyday roles and responsibilities that you'll have in the career and what that looks like as far as seeing patients and working with a supervising physician.

And that's where shadowing comes in again, because it's going to look so different depending on what area you're in.

A surgical PA is going to work much more closely with their supervising physician than I do.

Yeah, they'll be in the operating room with that physician mostly all the time.

And probably collaborating on every single patient.

If they're doing pre ops and post ops, there's going to be a lot of communication there.

And my supervising physician does sign all of my notes, which is a requirement for Georgia.

And so she's seen what I'm doing, and if there's ever a question, she'll bring it up.

But I think part of her trust in me comes from the fact that she trained me.

And it's funny, because a patient, if I saw them and said something to them, she'll come in and say the exact same phrase.

And it's because she trained me and I do things the way she does.

You're like a little mini me.

I mean, honestly, her biggest compliment to me one time was like, you're basically me.

I'm not perfect and you're not perfect, but if anyone was as close to me as possible, it would be you.

And I was like, thank you.

I take that as a compliment.

So it's great that you have an awesome working relationship with your supervising physician.

Where do as a medical student, maybe who's going on to be a physician who's going to work with PAs in the future, or a pre PA student who's going to go and be supervised by a physician at some point?

Where do you.

Does that relationship go wrong to where the PA hates the physician, or maybe just more in general hates being supervised and wants to be more autonomous?

I really like that question, because this is such a big issue, and I think it's an issue on both sides, because I think as a pa, you need to know what you're getting into.

You need to be okay with someone looking over your shoulder and giving you their opinions.

And if you're not okay with that, you shouldn't be a pa.

But I think on the flip side, like you said with med students, I don't know that med students get a great exposure to PAs, and I don't know they understand.

And the reason I'm saying that is because my husband did not know what I did until I graduated.

And it's so funny, because we would be studying.

I'd be studying with him, and he would have a cardiology question, and I would know the answer, and he would just ask me, how do you know that?

And I would say, what do you think I learned in PA school?

And then I would come home and say, oh, I excised a cyst today and sewed it up.

And he would go, you do that.

And again, you don't just check vitals.

What do you think that I do?

And so it wasn't until he got into rotations in the hospital, which I had already graduated at that point, was working.

And it wasn't until he was really in residency working with PAs, that he said, I really understand now what you do on a daily basis, and that there really are some great PAs and nurse practitioners out there.

And so I think, I think some medical students who just have never been exposed to PAs have a misunderstanding of what exactly the role is.

And so I think for med student who's going to be a future physician and have a PA that works under them, I think it's important for them to understand what that role looks like and what the capabilities of a PA are.

And I've seen that even in my own practice.

We had a couple of physicians come and join our practice, and they had never worked with PAs.

And after a few months, one of them came to me and actually said, I'm very impressed by what you do, because I didn't know that PAS did that.

It was kind of a mindset change for her because at the beginning we would have a suture removal or something, and she would say, oh, the PAS do that?

And I was like, actually, we don't.

The medical assistants do that.

And so it was just.

She just didn't know.

And so I think that's just where education of really the general population and students and everyone comes into play.

Talk about that.

Talk about that for a little bit.

The general population.

Oh, gosh.

As.

As a pa, so.

So for.

For my medical.

My pre med students who are thinking about and are conflicted with PA versus mdo, and for your pre PA students who are conflicted, do I take that next step up?

You talked about it a little bit already.

If, if you're thinking pa, but you're not comfortable with having a physician looking over your shoulder, then don't do it.

What about the patients, though?

As a pa, how many times are you faced with a patient who's like, why am I not seeing the doctor?

It happens less and less.

And I think that a lot of that is Because I have my own patients who have only seen me now, but it definitely still happens.

And there's a saying that if a patient sees a bad doctor, they'll find another doctor.

If they see a bad pa, they'll never see a PA again.

And I think it's very true.

And I have run into that a couple of times.

And I think it comes down to just earning your patient's trust and respect by being a good provider, no matter what your role is.

And we all make mistakes and we can all mess up, but I think it's also on you as a person and as a provider to make sure you're as knowledgeable as possible and that you're really providing that best care that you can and continuing to learn and stay up to date on everything.

So I run into that issue a good bit.

It doesn't help that I look extremely young.

And so I would say I get asked a lot, like, you're not old enough to be a doctor.

And I'll say, well, I'm actually not a doctor.

I'm a physician assistant.

And then the questions come a little bit because I always introduce myself, no matter what, I walk in the room, I say, hey, I'm sorry, Savannah, I'm the pa. And every once in a while, they'll say, well, when are you going back to finish your doctor doctoring?

When are you becoming a doctor?

And so I just take those opportunities to explain to them, well, I'm done with my schooling, and I was trained here by my supervising physician.

And I think because they trust her, and when I first trained, she made sure that I was introduced to many of her patients.

And so because they trust her, they trust me and they know.

And I let them know that if they ever want to see her, that's fine, that I'm not offended by that.

They just have to let me know or let upfront know when they're scheduling.

And that's something that I'm just okay with.

But it does take just continuing to educate people and slowly earn their trust.

So I think that's another box to check if you're on this pre PA path of being okay with having a physician looking over your shoulder being okay that the patient may want to see the physician sometimes.

And not if you're not okay with.

That, then you need to move on to MD or something else, because it's something that you will.

You will deal with.

I love the saying, check your ego at the door.

And it sounds like, as a pa, it sounds like you've done A great job of that big.

Look, I'm a pa.

I know exactly what my.

My quote unquote role is here.

The physician knows her role.

I know my role.

We.

We live happily together in our roles and it works great.

But it sounds like as, as a pre PA student, you need to be okay with those rules.

Yep.

And not just hope that one day PAs are going to be autonomous.

And I can't wait till we get to that day.

Right.

And that's something that interviews for PA school are looking for.

They do not want those students who think they're going to be what I call a fake doctor and go rogue and do whatever they want.

That's not what they're looking for.

They want people who understand this is a collaborative role.

And it's something that you are working as part of a team and technically under a supervising physician.

Which I think to some people could carry a negative connotation.

But for me it's a benefit and it's something that I enjoy.

Having that you've mentioned that a couple times about bouncing ideas off of her is.

Is that just your mentality and knowing your limitations and liking having that backup there versus versus somebody else who might also be a PA or pre PA going and having.

I don't want to say it's a lack of confidence, but just having that extra security there.

Is that just your personality?

Yeah.

I don't think that you should go into this if you feel like you can't be confident in your decisions.

I think for me it really is just putting our heads together.

And that's something I've always loved to do.

Like whenever I'm studying or whenever I'm learning something, I like to talk about it and I like to get all the information that I can.

I am a chronic over researcher and it is a blessing and a curse.

But it's nice for those just difficult patients.

And no matter what area of medicine you work in, you will have the difficult patient with difficult diseases.

And so I love having, I think just her experience and it's interesting to talk to her about when she first got out of residency and when she was completely on her own and how difficult that was starting out because she opened a practice and it was just her.

And I think she missed what you get in residency with talking to your fellow residents and attendings and kind of bouncing ideas off of each other to learn.

And so sometimes, and I know some PAs won't love this, but I refer to myself as just a lifelong resident because I feel like I constantly want to be learning as much as I can.

And I don't want to lose the interest that I have in dermatology or in medicine.

And so I think by us discussing things and if we read an interesting article, we always share it and talk about it because we both want to continue just learning.

Yeah.

I mean, that's the stereotype is lifelong learner.

Yeah.

My theory on that is if you want to be good at anything in life, you need to be a lifelong learner.

Yeah, yeah, exactly.

And I think for you getting together with the physician to bounce ideas off of you, said the physician likes to bounce ideas off of you.

And from a physician standpoint, we always, if I had a difficult patient, I'd go, I'd walk into my colleague's office, be like, hey, dude, what's going on?

What do you think about this?

So I think that's medicine in general, where everybody's bouncing ideas off of everybody else.

So that's not a PA physician specific interaction, but it's good that and I.

Think it's something that anyone in medicine should be doing if they want to again, provide that best care.

If there's something you have a question about, you need to put your heads together and try to come up with the best answer possible.

So what would your advice be to people who are trying to decide between MD and pa?

Typically, I encourage them to shadow a lot and do some soul searching to decide if they would really be happy in that collaborative role and not as the ultimate decision maker.

So I'd be interested to know what your advice is on that.

So 100% it's shadowing.

You have to shadow, you have to shadow, you have to shadow.

You have to go out and see what a PA does and interact with the pa, watch the PA interact with a physician, listen to how the PA talks about being supervised by a physician.

Try to find, just like you would in shadowing physicians, try to find PAs in different specialties and see what those interactions are like.

Understand.

I think this is an important part that I don't really talk about from the medical student side of things, from the pre med side of things is find out and maybe you have some advice for this resources.

Find out the state that you're in, the state that you're shadowing in, what those rules are for PAs and how autonomous they can be because you may be living in a state that you're not going to end up in and end up practicing in and you go and shadow a PA and they're very autonomous.

They don't Interact with a physician all day and you're like, oh, this is awesome.

Like I can be a PA and go to two years of school instead of four and no residencies, but then you end up moving to a state that's not PA friendly and now all of a sudden it's not the life that you thought it was.

So maybe you have some resources for pre PA students and even pre med students that are thinking about PA school to figure that out.

Yeah, that's a good point.

And I think there is one website that I have linked on a lot of my blog posts by Barton Associates where they have a really great graphic that shows different requirements for different states.

Very basic things when it comes to being a pa.

But for the ultimate answer, it's going to the state medical board and looking at their website, but also just asking PAs who work in that state because they're going to be your best resource for finding out what it's really like.

And I think sounds like a good resource you could create.

Oh yeah, it would be.

Go and aggregate all that information.

Yeah, except for it changes so much.

That's the only problem.

And yeah, it's just constantly, constantly changing, changing.

But yeah, I think just trying to get that firsthand knowledge and I completely agree with you, shadowing is the best way to get out there and kind of see what it's really like if you're trying to make that decision.

So as someone who went into medical school, is that something that you always knew and felt like you wanted to do or did you consider other healthcare careers?

How did you end up making that decision?

So I was in high school, I thought I was going to be a physical therapist and then I dissected a cat and I wanted to be an orthopod, I wanted to marry that kind of sports related PT stuff with cutting.

And so I joke that I wanted to be a doctor because I wanted to cut people.

And so the PA world never crossed my mind.

And maybe it was just PA school wasn't as popular back when I went to school.

So it was a while ago, a little bit older and maybe just wasn't as popular, not as many schools, but it never crossed my mind as far as going to PA school versus medical school.

Okay, another question, and this is something that's a little brought up every once in a while in the PA world, is that there are some MDs that feel like PAs are encroaching on their space.

Is that something that you feel at all or have any thoughts on.

So I think just as we talked about how if you want to be a pa, then you have to be comfortable having a physician looking over your shoulder.

I think There are physicians, MDs and DOs who just don't know how to play well with others and that you're going to find those personalities everywhere in life.

And so sure, there, there are going to be physicians out there who don't know how to use a pa as you talked about, don't know what a, a PA can add to their practice, to their ability to see patients and treat patients.

Yeah.

And so I think, I think with that knowledge, if you're a PA or a pre PA and you're coming up through this world and you start working with a physician who just doesn't know how to play well with you, just go and find another physician, get out of there.

There's gonna be, there's good, good doctors and bad doctors and good PAs and bad PAs.

It's, it's everywhere in life.

So I don't think it's really physician specific to say, oh, physicians don't like PAs.

I think there's just some physicians out there who don't know how to work well with others.

Yeah, that's a good way to put it.

And one thing that you touched on or kind of mentioned that I think, to expand on, I think another thing, if you, for your pre med students, if you're considering being a pa, you also need to be okay with the fact that you're going to make less money than the doctor and you are going to make money for them.

And again, for me, I'm fine with that.

I see myself as my physician's assistant and I think that's just because she has been really great to me.

I could see myself being very bitter and resentful if I was in a different working relationship.

But I mean, I know that I make money for the practice, but I'm also compensated very fairly for my time and I don't have to deal with any of the administrative stuff.

I come to work, I see my patients, I go home.

And so I appreciate that and I'm okay with that.

And they're fair to me.

And I think as a pa, you do have to know your worth to the practice and to the doctors and be okay to fight for that a little bit if you need to.

But you can't also expect the same compensation that a physician is getting.

It just, it's not necessarily going to happen.

Yeah, I think there's liability issues.

The physician is more liable than, than you.

Yep.

I think from a practice standpoint, at least at this point, most states you as a pa, you have to be supervised.

And so the physician is the one that owns the practice in most instances and spends all of that overhead, money and marketing and everything else.

And so yeah, you're, you're earning 70 cents on the dollar or whatever it is that you're bringing into the practice.

And it's just something you have to be okay with.

Right.

Is there anything working as a physician that you, or even going through medical school, any part of it that you hated or that you wish?

I hated medical school.

You hated all of it.

I hated the pre clinical year, so I had taken three years off between undergrad and medical school.

I didn't get in the first year, took some time, fixed my application, got in and I forgot how to be a student.

So I was miserable studying and learning and I enjoyed anatomy.

That was the only thing I liked because I also came in very close minded and said, I want to be an orthopedic surgeon.

Why do I need to know biochemistry?

So I was miserable those first couple years and then once I got to the clinical rotations the second two years, I was happy because I was interacting with patients, I was in the hospital, I was doing what I wanted to do, to do.

But it's, it's a grinding, long process.

And so that is another thing.

You have to know yourself.

Are you going to be able physically, emotionally, mentally, are you going to be able to survive medical school, residency, fellowship before you actually become a quote unquote real doctor out there working?

And I think I need to make this differentiation.

A lot of students will go, I'm not smart enough to be a doctor, so I'll be a pa. And I think that's just silly because as you stated earlier, you're learning the same stuff.

Right.

It's just you're learning a lot less of it for a shorter amount of time.

Medical school, and you can speak about PA school.

Medical school, you don't have to be a genius to do well in medical school.

You just have to work hard.

Mm.

I don't know if it's, if you had the same experience with PA school.

I think I feel the same way.

And I think PA school is just so much information so quickly that it's very easy to get overwhelmed.

But the nice thing about it is that it is information that's more relevant, I feel like, and more important for the future than when I'm sitting in general chemistry and I Feel like it's not helping me for my future really.

So I think that part of things made me enjoy the didactic year of PA school more.

And that's something that me and my husband talk about sometimes.

And I think we talked about it more right after I graduated.

The fact of I really feel like I could have done med school and that first year probably I did have some doubts, like maybe I should have done that.

And looking back, it's funny to me that I thought that, but just kind of watching him struggle through it, like you said, it's just so difficult.

And I think part of what makes it difficult is those comprehensive exams and I think those are intimidating and can just be such a difficult part of the medical school experience.

Yeah, I agree.

It's a lot of work.

So we talked about people who don't think they're smart enough.

What are your thoughts about people with lower GPAs trying to get into medical school or switching to PA?

That would be my most asked question.

Is I have this low gpa, can I get into PA school?

Do you get the same types of questions with your Pre med students?

100%.

And, and I think there's also that next level is oh, my GPA is not good enough to get into medical school, I'll go to PA school.

And I think it's, it's silly.

I mean, we've talked about that.

There are differences there.

Well, there are differences, right.

So you can't.

PA school shouldn't be plan B for somebody who wants to be a physician.

Unless you are okay with everything that we talked about already.

Right.

And so having being a PA as a plan B right off the bat just is silly because it's two different careers, first of all.

And then second of all, if you have a poor gpa, you can still get into medical school.

It may not be as fast as you want, it may take a couple extra years, you may have to do a couple extra things.

But if, if you have a low gpa, there are ways to not, not fix it, but there are ways to overcome it, to show and to prove to the admissions committee that you can handle medical school.

That's what they want to know.

They don't want to accept a student who's going to fail.

That's just, it looks bad on them.

It's wasting a seat.

And so they, they, that's why MCAT and GPA are so important.

They're not the end all be all though when it comes to getting into medical school, a lot of students will start off College with poor grades, having a bad transition from high school to college, very different way of learning, very different lifestyle.

And so students will do.

A lot of students will, will try to put too much on their plate as well those first couple of years and then they get bad grades.

But junior and senior year they have three sevens, four O's.

And I try to tell them not all GPAs are created the same.

If you have a strong upward trend with your gpa, whether that's the last couple of years of undergrad, or you did a postbac and your postbac grades are great, or you did a very science heavy master's program and that looks great.

And not, not a master's program like an mph which isn't very science heavy, but a very science heavy chemistry, or even a special master's program specifically for being pre med.

Having that strong upward trend will help you overcome a low gpa.

That's basically the same advice I give to my pre PA students.

If you really want to do this, there are ways to get there and the backup they tend to go to is nurse practitioner, which again, it's a different career.

They're very similar, but the path to are very different to get there.

And I think if you want to do PA and you are set on it and you would be happy with that, then that's what you need to keep working towards.

It's funny, we have the same conversations with students.

It's just a different language that we're using.

Yeah, exactly.

Well, hopefully you can help out some of mine that decided to go the.

Pre med route and hopefully you're there for those that are thinking that PA might be better choice for them after deciding that being pre med isn't what they want to do.

Right.

Thank you for taking the time to chat with me about being a PA and the whole pre PA path.

I know my audience on the pre med years will enjoy it a lot.

Thank you too.

I think this will be so helpful to all of my listeners.

So there you have it.

That is the interview and I hope that you learned a lot.

I think it was just great to have that conversation with someone on the other side of things.

Again, I know this is a very tough decision for some people and so I want you to have all the information that you can when you're trying to make that decision.

So let me know what you got out of this episode.

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