Why a PA career may be wrong for you

Look first, or you may regret it

It’s easy to get excited about a physician assistant career.   I wrote recently about how to tell if you have the PA personality.  But what about the values you hold?  Excitement has a way of discouraging us from seeing the little negatives we sometimes need to see.  So today’s topic is a little different – 180 degrees, in fact: how to tell if it’s the wrong field for you.  Here are five big ones as I see it.  If you have one to add, float in a comment below.

5 Reasons a Physician Assistant Career is Wrong for You:

  1. Your job title is more important to you than what you actually do. I’m not being snide here – for some people (and they usually know who they are), the prestige attached to job titles is crucial.  If you’re one of these folks, think twice about a PA career.  Why?  Even though PAs are gaining acceptance in the eye of the public every day, they have a way to go; many people still don’t really know what a PA is.  To be one is to accept that you will be explaining your role to your patients as a normal part of your work.  You will occasionally be mistaken for a medical assistant or a doctor.  You will be neither, and it’s your job to patiently explain what you are and do.
  2. Your interest in medicine is more about the science than about caring for patients. Don’t get me wrong – as a PA, you’ll need to know and work with plenty of science.  And PAs aren’t the only medical providers who care about their patients.  But as a PA, your patients are a larger focus.  Your communication with them and your ability to educate and counsel them about their health and treatment are your “magic bullets,” not your specialized knowledge of biochemical pathways or fluid dynamics.
  3. You need to be at the top of the decision making chain on every decision you make, as opposed to working as a member of a team. PAs are supervised by physicians.  They make many decisions independently every day.  But sometimes the supervising MD makes the call.  If you can’t stomach the idea of not having the final say about everything that  happens with every patient, you shouldn’t be a PA.
  4. You prefer to be the expert on one or two subjects than to be competent in many. One of the recognized strengths of the PA profession is its flexibility.  It’s great to be able to work in, say, primary care for a few years, and then switch to a job in emergency.  It leaves you open to more employment opportunities, and it’s one reason PAs are so sought after; they are “physician extenders.”  But it’s not ideal if you want to be the regional or national expert on a particular illness or procedure.
  5. You think it’s an easy way to get into medicine. Medicine is hard, in part because it’s complicated, and in part because there’s simply more of it than you could learn in three lifetimes.  It takes fewer years to become a PA than a physician, but there isn’t much about it that’s easy, and believe me, you’ll still be learning when you get out of school.  It’s loads of work and time to become solid, and a PA’s mistake can kill or harm a patient just easily as a physician’s.

If you have thoughts about these, or have one to add, just leave a comment – we’d love to hear what you think.     -P

  • emedpa February 21, 2011, 8:44 am

    re: #3
    pa’s who work solo em or primary care are at the top of their decision making chain.
    any comment an sp makes is often days/weeks/months after the fact and more along the lines of quality review/recommendation as they can’t change what you ahve already done. many states allow for 10% chart review within 1 month which leaves A LOT of room for independent decision making.

    • Paul February 21, 2011, 7:54 pm

      Every PA reports to a supervising physician. Yes, for many that means that 10% of their charts must be reviewed by a doc, but that means –wait for it–that you aren’t at last word on all of your patient decisions. In practice, PAs make most of their decisions without any feedback whatsoever, but the good ones know when to consult with their supervising MD. I think I agree with your comment overall, but just to make myself clear, I changed #3 to read “You need to be at the top of the decision-making chain on every decision you make.” Good point, and thanks for the feedback.

  • Anonymous February 21, 2011, 2:18 pm

    I remember reading in one of those article that shows the PA profession as the second best job in the US, that one complain was that there is no opportunity to advance to the highest position (without going to medical school). I guess that is why they call it “mid-level”. So, if you need to be king… But then again, I have heard of PA’s opening their own clinics, running the show, and being the one to hire and fire the providers (including docs), so I guess it depends on what the definition of power is 🙂

    • Paul February 21, 2011, 7:59 pm

      Well said, Sundance.

    • woot January 17, 2015, 5:26 pm

      I know a PA who does this very thing: he hired one of my in-laws to be the MD to supervise him and he owns the clinic in which they both work.

  • DrRandy February 25, 2011, 12:43 pm

    I find your implication that physicians are elitist and title-focused offensive, as I do your implication that physicians are not patient-focused. It is a well-known truism that for most of us, the details of biochemistry and physiology are background, and of no immediate application in day-to-day practice. That does not make us science geeks. I teach my residents every single day to treat patients, not lab reports, and I teach them that their patients are people, not diagnoses. You tar an entire profession with far too broad a brush.

    • Paul February 25, 2011, 4:24 pm

      Dr. Randy, it seems I wasn’t totally clear. My article was not about physicians, but those who are considering becoming physician assistants. My point was that if titles are more important to you than what you do at work, you probably shouldn’t become a PA. Maybe I should have said that if delving deeply into the scientific underpinnings of medicine is a requirement for you, you might find more satisfaction as an MD. But I purposefully avoid saying things like this so as not to mislead students into thinking that the science in PA training is easy. Since you bring it up, I’ll add my opinion that if the science is all that interests you, you aren’t destined to much of a physician either. I have great respect for physicians and their work. My father was a physician, and though he was a great scientific mind, the human element was always the most important part of his work, and the one in which he took the most joy. I’m glad there are physicians who read this blog – it will keep us honest, and provide perspective.Hopefully I’ve narrowed my brush by a few bristles.

      • Hhammond January 15, 2014, 7:40 pm

        Hey Paul,
        After reading your article I was concerned that the PA career path may not be for me. I am currently a freshmen at the university of Michigan and still very un-decisive about my career path. I work as an MA at a gynecology clinic for a well know hospital. I enjoy working there and I enjoy learning new things everyday. I like caring for patients and sometimes go beyond my medical duties to help the patients. I very much dislike being ordered around constantly by the doctors. Also, I don’t tolerate bodily fluids well ( it grosses me out at times). I wanted to go into the PA program because I have much experience in the medical field and enjoy practicing it. The PA program is also a good job with stability which also pays well and it allows me to have a life. ( these were also considered in helping me decide). My question for you is whether or not I should go into the PA Program? I believe that I can really care for patients and become compassionate in what I do. I also cant imagine a job outside the medical field.

        • Paul January 19, 2014, 8:22 am

          This is a tough question and I would tell you that choosing to go to PA school or not is a very personal decision.

          PAs are rarely ordered around by anyone. They are supervised by a physician, which USUALLY means that doctor is available if the PA wants to run something by them, and that that doctor cosigns at least 5% of the PAs charts. In practice, PAs – once trained and possessing some experience – practice pretty much independently. I should add that all of this depends on the supervising physician that the PA works with and the relationship between the two. Doctors are human and therefore prone to human weaknesses. If your supervising physician is controlling, micromanaging, temperamental, inappropriate, abusive, or otherwise difficult, they can make your life hell. But this is rarely the case. More often the PA and MD relationship is collegial and cooperative.

          As for bodily fluids, you will definitely run across them, particularly while you are in training. Body fluids are a nearly unavoidable part of medicine. On your side, however, is the ability to choose a specialty that keeps them away from you, such as psychiatry, endocrinology, orthopedics, etc. In a very famous book read by medical and PA students (The House of God by Samuel Shem), the main character has this problem and ends up becoming a psychiatrist. They talk about the so-called “no patient care” or NPC specialties, which are psychiatry, radiology, pathology, etc. because they don’t require you to tough patients.

          Sounds to me like maybe you should spend some time shadowing a PA – that way you can get familiar with what you will doing and have no illusions about it.

          I wish you luck in your decision making process.


    • PA Studnet April 2, 2012, 12:12 pm

      I have to agree with DrRandy.

      First let me say I think both fields are great.

      But I agree that the authors of this website have made comments that while commending the practice of being a PA, imply that being a doctor means that you dont focus on the patients, don’t enjoy working as a team, and are a science geek.

      I know that you are a PA, but try to not be so denigrating in what should be a more objective piece.

      • Paul April 2, 2012, 1:31 pm

        Thanks, PA Student. I enjoy a good controversy! As I’ve said, they’re both great fields, but they aren’t both great for very every person – it’s the fit that counts. So I’ll stick with what I’ve written – I think it speaks for itself.

    • Alexandra, CPhT May 29, 2012, 12:56 pm

      It seems to me that people reading this are taking what is meant to be directed at a targeted audience and going off into directions that stray away from the purpose of this article. I am the targeted audience, I am a certified pharmacy technician and I am currently looking into several healthcare related careers (Nursing, PharmD, PA etc). The very first thing everyone tells me as an aspiring healthcare program student is “if you are interested in applying to this program only because you think you will make a lot of money or your parents are making you do this then don’t do it, you have to WANT to take care of people”. I think that is what the author is trying to convey here. He is warning people that this profession requires passion for patient care and if that isn’t your main intention you really need to do some soul searching before you commit to this kind of career path. I have friends who went to pharmacy school, medical school and PA school solely because their parents forced them to. Now, they hate it because that isn’t what they truly want to do. I told a co-worker who was applying to medical school that I believe she should rethink her decision because she hated every single patient that came through the pharmacy. She made negative comments and made fun of these poor sick people, I just looked at her and said, “are you sure you WANT to take care of these people?” I don’t think she was sure. With that being said, I appreciate this article and all of the people who are giving information to students or generally interested people who may want a career in this field. I honestly hope that the “controversy” between MD’s and PA’s here isn’t a sign of how the relationships between the two really are. Please be aware that it’s discouraging to kids looking for real perspectives and information when people start using these forums as a way to belittle others opinions and take attention away from the point of the discussion. I work hard and don’t want to waste my lunch break researching my future only to find that I just wasted half of it reading people attacking one another instead of providing me with useful info!

  • Amondre February 14, 2012, 2:05 pm

    Honestly, I think that becoming a PA is of the utmost rewarding profession. I am currently a PA student at Wake Forest University, and I have friends who are in the Medical School Program here. Sometimes we sit down and analyze our assignments holistically, and, in turn, the assignments are essentially requiring the same amount of time, cognitive thought and work levels. Yes, you’re right about having to consult a Physician at times, but I think that’s what makes one a better PA — taking the initiative to ask questions in the event that one is unsure, so that the next time you’re place in a similar situation, you’ll know exactly what to do. Furthermore, I think that a PA should be well-rounded, and not fully focused on one specific practice. Here at Wake, patients have a multitude of illnesses and it feels prodigious when we’re able to detect the illness, and help cure the illness. Moreover, being patient-focused seems like the better route in my book — my professor always says, “patients first, diagnosis whenever they are needed, but not when they are wanted” which merely means that if one is in PA school for the love of Medicine and Science alone, and have no prior adoration for patients — he or she may want to choose an ancillary direction in his or her life. PA’s are here for guidance, advising and we’ll always be there for our patients.

  • tia March 15, 2012, 4:39 pm

    If you become a PA and decide that these things do, in fact, bother you, how easy is it for you to become an MD. Do you have to start all over from the beginning of medical school? Or can you skip a few years? Or are there special tracks for PAs becoming MDs?
    I ask because I’m trying to pick between the two. I’m able to do both but I’m just not sure which one will make me happier, so I’m just trying to understand my options.
    Thanks so much

    • Paul March 15, 2012, 4:51 pm

      Unfortunately, being a PA doesn’t save you any time if you ever want to become a physician. Of course, you probably would have some of prereqs already taken care of (physio, micro, etc.). And although there’s been much talk of the introduction of a PA fastrack to MD program, no such program has ever materialized. I suggest you consider the matter carefully; if you become a PA and want to switch to physician, you start your medical training over from square 1; if you become an MD and decide you want to become a PA, you may get in, but you will be carrying a very heavy burden of debt and you’ll be on a career track that won’t pay it off as easily. If possible, I say choose one and stick with it. Good luck.

      • PAEvan April 10, 2014, 9:13 pm

        Great discussion board. There’s a lot of good topics here, currently I am finishing my didactic year in PA school, I had military, EMT and Sport medicine training and psychology training (undergrad) before starting PA school. Like many people it was tough for me to decide which path was best, but I was accepted to PA school and I decided I had nothing to lose. There are some paths and programs in the works that I have heard of that take one year off of medical school if you so decide to go that route if PA is not satisfying you. But it’s hard to imagine that being the case. You get autonomy, a high level of knowledge, and respect in the work place. You make a good salary and are able to work in any setting imaginable. I talked with a pediatrician the other day about this, and his advice was to get my PA, work and if I didn’t feel satisfied, to apply to medical school and use all that knowledge to my advantage. I can’t imagine that I would need to do that now, since I intend to work in primary care my salary would not be all that much different, and my job would be almost identical with about 200,000 more bucks of college loans, however, it is an option, and I would never call going back to a school a BAD idea. Just something to think about.

  • rdb March 16, 2012, 7:53 am

    I love the medical profession. Let me be clear, I am not a doctor or pa, but I know many good ones in both professions. I have enjoyed the fortuity of having very professional and caring primary care physicians and pas for most of my life (one dr literally saved my life because he was concerned about me and not the consensus diagnosis of several other doctors). I praise God for him.

    Anyway I am in a place in my life in which I must make a career change. I have asked myself for over a year what can I possibly be passionate about beside my previous employment. I have struggled with that question for over a year. I mean it has been struggling!

    Now as I was at my pain pa the other day, it came to me. I could be passionate about being a pa. I have always had a strong interest in the medical profession. My wife manages 2 clinics at a major children’s hospital in the midwest, and I love to talk to her about the challenges and such that she faces each day. Because of hippa, there are things, she can’t discuss of course, but what she can she does and I love it. Especially the difficult diagnosis and treatment the docs have had to figure.

    I have been thinking and researching this now for over a month and I am still excited about the possibility. The question or topic that I offer for your advice is; do you think I have a chance of being accepted into a program, and do you think it is a good choice for someone my age. I am 52 years old. I have a bachelor’s degree in ancient literature and graduated with highest honors (above 3.8 out of 4). I don’t have the prerequisites, but that’s not a problem I am looking into making them up in the next year. I have a great memory. My study habits are excellent and I have above average IQ and very good EQ.

    I believe in getting advice and opinion from many sources and yours would be a great help. Be honest with me please and tell me what you truly think.

    I will thank you ahead of time. Thank you very much!

    • Paul March 17, 2012, 12:06 am

      Hi, Rdane. I’m not big on answering the very common “what are my odds questions” with actual odds. There are so many variables, the biggest of which being the whims of each admissions committee. But here are my thoughts:

      At 52, you won’t be the oldest person to go to PA school, but it will definitely make you one of the older/oldest people in your class. In my class the oldest person was 54 (if I remember correctly). More than anything, it depends on where you apply. I suggest you call around and ask how they feel about older candidates. If they don’t like them, they may say it flat out. If they don’t mind, they’ll say something like “We look for the best candidates, but more than anything want strong students who are a “fit” for our program. To me, this means age isn’t a make-or-break factor.

      Should you go for it? It’s a personal decision, but if you feel passionate about it (as you said), I think you should take that feeling very seriously. Strong clinical experiences will help you, so make sure you have or get some good health care experience. We have a section on that at Inside PA Training, so be sure to check that out.

      if you think it’s a long shot, maybe hedging your bets would be wise. You could take your prereqs, get a job somewhere in the medical field that interests you, and apply. If you don’t get in or change your mind, you’ll have learned plenty that will come in handy in another “wing” of the medical field.

      I urge you to think creatively about this new interest. Being a “nontraditional student” usually means using some “nontraditional” thinking/strategy to make it happen.

      I hope this helps – be sure to get active on the forum where you can get the thoughts of others too.



  • Amerae April 7, 2012, 5:26 pm

    Hey Paul,
    I just wanted to back you since I came across this site right now and read all of the comments. In no way did you ever even mention doctors in your #2 reason (your interest in medicine is more about the science than about caring for patients). In fact, you could have been actually pointing out without saying it, that both PAs and doctors and nurses (clinical medical fields) all have a broader focus on a patient. Instead it seems that a few doctors on here took it the opposite direction (argumentative and unproductive) and felt that you were indirectly saying that PAs have a broad focus on patients while doctors do not. That is just ridiculous! It was never even said!! What is wrong with people who always try to see the bad in a great and helpful posting like this? This was a short and sweet and to the point posting, from an obviously educated person who was in no way trying to talk about how MDs don’t care about their patients as much. I commend you for letting your words speak for themselves and others can just read the post over if they cannot critically think and comprehend this simple post.

    • jw June 20, 2014, 3:51 pm

      I tend to agree that there was not a clear implication that MDs are focused on the science and care less about the patient. My dad’s an MD and I love him very much, but there are plenty of docs I’ve been to that have very poor bedside manner.
      I work in the software industry and have considered going back for a PA and it did not occur to me that #2 was directed at MDs. I can see their perspective but it seems a little self-centered to assume that someone’s comment is aimed solely at you.

  • Heba September 3, 2012, 9:21 am

    Hello! well I am writing because I have been looking for info about PA for long time but still undecided and I need feedback from those who are the Masters in the field like Paul :). I am between bioengineering or medicine since childhood I wanted to become a surgeon specializing in Pediatrics Cardiologist, then life changed for me I became a Paralegal and wanted go into Law School but realized that law is pretty in books and not so about justice. The thing is that I started engineering but I no like so much math but I love science and research I wish become surgeon but I cant stand vomits lol but I can stand blood. Is weird but that a fact when I see someone vomiting or nausea or even doing those noises with the nose my stomach become totally disaster 😀 what u advise to me is that normal for MD or PA students? Will that go away over the time? or i just simply try to get into another field.

    TC and I love this blog

    • Paul September 3, 2012, 9:51 am

      Nice compliments – thanks!

      I think if you can make it through your training (in which you will need to have some of those experiences), you will be fine. You can choose a specialty that avoids those things, such as psychiatry, endocrinology, medical cardiology (non-surgical), or one of many others. The not liking math thing could be tough, but I will say there isn’t really any advanced math in the PA field – only basic math and understanding mathematical concepts, such as logarithms.

      There are plenty of medical students with similar issues. I recommend for truly fun reading and reassurance about how to handle this that you check out an amazing book called The House of God by Samuel Shem. I did an article on it a while back, which you can get to by clicking the link in this reply. Good luck! P

      • Bernard kwamena Sayikah July 25, 2014, 7:39 am

        I am a graduate nurse and can’t wait to enroll as a PA student. Am really enjoying the forum

  • Meg September 24, 2012, 7:28 pm

    Thanks for this article. I already work in the health care field as a Registered Dietitian, but I want to do more than just counsel people on diet, food, and weight loss. I am currently praying about a career change: probably either PA or med school or a professor or something. I just love medicine, how the body works, diseases progress, and just KNOWING things. But I can’t decide which one: I like having knowledge and the “delving deeply into the scientific underpinnings of medicine” that being a physician would supply. But you don’t use that information everyday to explain to the patients, so it just slips away. But I also like explaining to people about what is going on inside of their body, so as a PA, I would study the information and be able to do some education.

    And I do love people and helping them by solving their problems, but after reading your comment about “Your interest in medicine is more about the science than about caring for patients”… I was a little worried. And this probably sounds cold-hearted but what would be a career in which I just learn all the medical stuff and retain it, not patient-focused? A professor of A&P or Biochemistry or something? An epidemiologist? Thanks for your help.

    • Paul September 24, 2012, 8:15 pm

      Yes, I think those are good guesses. Or as a physician in a NPC (non-patient care) specialty, such as radiology, pathology, etc.

  • Malcolm September 29, 2012, 11:43 pm

    Paul i have a question. I going to school to get my prereqs done for the PA program at penn college of technology in pennsylvania, which is a Bachelors of Science program, and was just notified recently that i’m about to hit my limit in loans and grants..I’ll be graduating next year with my degree in applied science and i wanted to know do you know of any scholarships out there in regards to health careers. I’m 25 years old and i had started college years ago when i didn’t know any better and changed my major a few times and now i’m approaching my limit with little to show for it and i’m worried about my academic career not being fulfilled because of financial difficulty…i’d appreciate the info Paul, thanks and GOD bless

    • Paul September 30, 2012, 10:14 pm

      There are scholarships, but you’ll be hard pressed to finance more than a fraction of your education with them. Try fastweb.com.

      You might also contact the National Health Service Corps. They have loan repayment plans for health professionals who take jobs in underserved settings. You may need to take out private loans to get through. But once you have a job, payback shouldn’t be too difficult.

  • Eileen March 30, 2013, 7:59 pm

    I think you need to be intelligent and have good interpersonal skills to be an excellent doctor or physicans assistant. My problem with the medical profession is that they are overly focused on prescriptions and surgery. Sometimes, less is more.

    My reason for saying this is that I had gallstones and all the doctors said operate. I researched alternative treatments, and I am free of gallstones. They are too quick to suggest very invasive surgeries, which are not in the best interests of the patients.

  • Kurt Windermere PA April 4, 2013, 8:13 pm

    Paul, I love that you recognize that PAs are the true backbone of the medical field and I am glad you are guiding our youth to be PAs. Without our expertise and leadership skills physicians would not know what to do with their patients and may end up doing more harm than good because they are treating a disease not a person. I have just recently graduated PA school (which I must say betters medical school in most way: you learn more and you can do it faster because we are smarter than most docs) and I can’t wait to hear more from you about how PAs are finally being recognized as the true medical leaders

    • Paul April 4, 2013, 9:39 pm

      Thanks, Kurt! I think docs are very smart people too. But I agree that PA schools is more practical in many ways. Good luck with your new career – I’ll see you in the field, buddy!

  • Mitchell Garcia April 5, 2013, 12:30 am

    I am a senior in high school, graduating in about two months. I am very excited to enter a new phase in my life, going off to study in college and eventually going to PA school, but I am unsure of the “burn out” effects being a physician’s assistant can bring. I am one who likes to gather myself and emotions after a hard day of helping others by spending quality moments with my family, who will not be there in my years of PA school, or finding ways to relax and regroup my thoughts in solitude, which seems to be the only way I will be able to unwind as a PA. What are some ways to unwind after a hard day’s work of being a PA? Is it too much to ask for friendship in the office? Let me know if I am being to needy, so I can reconsider going into the health field. I am on the edge of discovering my life’s path here!

    • Paul April 5, 2013, 3:16 pm

      Mitchel –

      Theses are great questions.

      1) Your specialty choice will make a big difference in the lifestyle you live as a PA. Surgery is probably not for you (but hey, don’t take my word for it!)
      2) Everyone’s different with respect to socializing, and every office has its own climate. At some jobs you get written up for being inappropriate (with other staff members), at my clinic, you get “scored” on how funny your impropriety was. I love to socialize with my staff – Christmas parties, dinner and/or drinks after work, going out dancing, etc. are all to be found here. But in some clinics this doesn’t happen, as PAs are reserved for leadership roles that don’t work in social settings with staff. It just depends.
      3) There’s a big difference between being needy and taking care of your own needs. I think you are talking about the latter.



  • Kathy April 8, 2013, 5:09 am

    Paul, I really like your article. Well said!!! One of the frustration I felt is NO advancement. I’m working for DOD and I’m maxed out at the food chain of PA scale… I’m always wondering how I can get promoted and advanced in this career…

  • Mandeep May 19, 2013, 9:27 am

    If you have masters in cellular and molecular biology, how easy/hard is it to get into a PA program? I am shadowing a PA for last couple of months. I have done about 50 hours of shadowing so far. By profession I am an Anatomy, cell molecular, and Physiology teacher at a community college and University. I teach cadavers. Previously, I worked in a dental office for 5 years. Do I still need more medical experience to be able to get into UC Davis PA program? Please advice. I was searching UC Davis website and I have not found their PA curriculum anywhere. Could you help me with that as well?This is a great blog. You unknowingly are helping thousands of people. Thank you.

    • Paul May 25, 2013, 5:56 pm

      Thanks, Mandeep.

      You have a good academic background. Your work teaching and with cadavers will be very helpful. BUT, you also need more time working with living, breathing patients. Dental work is good, but it’s probably not enough on its own. I would suggest you try to get some acute care experience (hospital or ambulance).

  • Cham October 7, 2013, 10:52 am

    Paul, I have really enjoyed reading this article as well as all of the comments! Like many others, I too am having difficulty choosing between a career as a PA or an MD. I have a bachelors in Public Health, as well as a MPH in Epidemiology and Biostatistics. I value both career opportunities, and have spent many years in the health profession as a health educator, research coordinator, etc. I really enjoy interacting with patients and giving them the care and information they need to live a life that is healthy and prosperous. Titles don’t matter to me..I just really want to help people.
    More so, I am more concerned about time. Although I am young (26yrs old) I am recently married and in a few years I want to start a family. I just want to make the best decision for my family.

    Any advice?

    • Paul October 10, 2013, 10:26 pm

      Well, I obviously have a bias, but I think you would do well to seriously consider the PA profession. I earn a great living and work 40-43 hours per week. and I am never on call. I am paid by the hour (many are salary) which means that after 40 hours in a week, the remainder are time-and-a-half. I get as much medicine as you can shake a stick at. I make important decisions about patient care every day, and have much autonomy. I share serious news about patients and their conditions (telling them they have cancer, etc. – not that that’s joyous, mind you, but it’s important). I chose PA in part because I had children and I knew that if I went to medical school I would A) never see them, B) be too tired to be present when I did, C) would be dragging my family all over the country to whatever internship or residency I took (and just so they could not see me very much). In the end – and I mean after 15+ years, MDs will consistently make more money than PAs, but as I’ve said many times:



      Don’t mean to yell – it’s just a point that I really want to emphasize.

      • Cham October 11, 2013, 7:30 am

        Thank you for the advice Paul! And to be honest, I 100% agree with you. I think people do underestimate what it takes to be a physician, I mean a great and honorable one! lol After many years, months, weeks, and days of trying to make this decision, I am completely sold on becoming a PA! Either field requires both hard work, dedication, and compassion, but in terms of where I see my life, I believe PA is the way to go! thanks again for the pep talk 🙂

  • Kyle November 15, 2013, 10:58 pm

    Hi Paul,

    I am a soon to be graduate at UCSD and have CONSISTENTLY followed through with the pre-med track. It was only until I began shadowing in endocrinology, neurosurgery, and gastroenterology along with doing basic science research for an MD that I began to realize that medical school just does not click with me anymore, I no longer envision myself being content at all with becoming a clinician to that extent, and the future for MD/DO looks grim in my opinion. I still want to practice medicine however, but what I want it to be fulfilling, I feel that I am being led to the PA track.

    Is my frame of thought well to continue through into pursuing PA?

    Thank you!

  • Matt December 3, 2013, 1:07 am

    Hi Paul,
    Thanks for providing this website. I was wondering if you could expand more on the issue of whether or not PA is a wise choice if you’re more turned on by the learning/knowledge/education aspect than the patient care aspect. I’ve been thinking about a medical career off and on for several years (25 yrs old now, grew up with fascination with understanding how the body works, aspired to be a doctor). My recent clinical experience assisting as a surgical tech at a busy dermatology office (9 months) left me fascinated with what I saw, and I’ve had this ongoing desire to somehow learn and practice surgery. It sounds childish and naive I guess, but after watching hundreds of skin flap and graft repairs, I’m left really wanting to pick up a needle driver, forceps and suture and learn how to expertly perform surgery like the docs and PAs I assisted. Surgery looks extremely cool, and I’m pretty sure I would enjoy every day spent working with my hands in this highly technical way in the OR. I do realize there’s more to being a provider than doing procedures — surgical PAs and MDs have much more responsibility in their work, such as spending considerable time counseling patients, rounding, pre-op, post-op, transition of care, etc. Surgery just gets my attention.

    The narrow medical experience I’ve had so far (all at skin cancer surgery center, assisting with gathering patient histories, educating patients and families, relieving concerns, doing minor procedures like anesthesia and hemostasis, bandaging, assisting providers, etc) was rewarding and left me wanting to go deeper, but I’m on the fence about whether PA is the right fit. Besides a liking for surgery and fixing things with my hands, I’m a curious guy. By nature I ask a lot of questions, I’m frequently caught looking up things in medical reference books at work, and people have said that I should consider going into “research”, maybe because I seem so inquisitive. But I don’t really see myself wanting to generate new knowledge–I more want to be well equipped with knowledge so I’m prepared to help people. I want to serve people, and one way is to be well prepared to address a problem, to explain things well, to know what the right course of action is. So that’s one of the big draws for me about being a medical provider — I really want to be an expert so that I can be a resource for people: answering questions, explaining how things work, why this is happening, etc. And I would want to be equally knowledgable when it comes to performing surgical or other procedures.

    So what I’m trying to get across is that I feel drawn to certain aspects of what a PA would do in practice — the constant learning and teaching, the skilled execution of procedures, and in the services provided, when you get to see that you’ve met people’s needs in a real way. I’m not saying that I do not value “caring” for patients, per se. It’s just that I might have a different motivation for doing it. I think it’s fair to say that I want to help people, but more along the lines of service: I’m satisfied when I know I’ve met someone’s needs, and have done it well. But I can’t say that I’m a visibly “affectionate” person, which is the part of “patient care” that I’m wondering about. I’m more on the reserved side. I don’t have the bubbly, outgoing, emotional, or sentimental personality that perhaps you’re referring to. I’m gentle around patients and pretty much everyone, and I try to come across as friendly and easy-going, but I’m not touchy-feely. It’s just not me. You could say I’m a serious guy. I want to help people, but I don’t feel like I’m a natural when it comes to bonding quickly with new people, telling jokes or stories effortlessly, making lots of small talk, etc.

    Anyway, sorry to be longwinded, but I hope that makes sense. I realize becoming a PA is a big deal because you’re putting yourself in situations where vulnerable people who need help (and someone to depend on) are either better or worse off for you being there. I wouldn’t want to fail anyone who had put their trust in me by not being the right person for the role.

    What do you think? Any suggestions about what I could do to better assess whether I’m a good fit for the PA role?


    • Paul December 7, 2013, 4:30 pm

      If there is a surgery type (I believe there is) you sound like it. In surgery the emphasis is on getting the job done (properly), more than on pleasing the patient. Patient’s are to a certain extent seen as the vehicle through which your work comes to you, in contrast to primary care where they are more of the focus. I hope that if you do go into surgery you will push your comfort zone a little and learn to use what caring and personable side you have – to further develop it, even. There is very little about medicine that cannot be improved by caring for your patient and showing that you do.

      I too enjoy being an expert. I like to be able to tell patient’s what is going on, why, and what they can do about it. But I have found that that thrill weakens with repetition. What never seems to weaken is the feeling of accomplishment I gain from knowing my patients, securing their trust, and caring about them.

      It may just be a personal style thing, but surgery can be done with little heart, and in time (my opinion here totally) it can lead to callousness and burnout.

      I didn’t hear you saying that you’re callous or jaded at all. I would just hate to one day learn that your job had helped you to become so.

      It’s a good question, and you’re wise to wrestle with it.

  • MM March 24, 2014, 7:36 am

    As a someone who doesn’t *love* being a PA, I’ll share what I think:

    I agree with your list, but I think the most important points are #1 and #2, and to a lesser extent #3.

    Being a PA is primarily about patient care, which means spending actual face time with patients of all demographics for the majority of your workday. If you aren’t a people person, or if you find constantly being ‘needed’ draining, DO NOT get into medicine. You will find patients demanding, ignorant, and non-compliant; office or hospital staff relentless, and SPs demanding as well. Yes there are moments of satisfaction, but wannabe-PAs need to understand that the majority of patients in any specialty will test your compassion and your patience.

    PAs are generally pretty far removed from basic and clinical sciences. Day to day practice is more about efficiency and getting patients in and out, rather than technical decision-making and medical detective work. There can be some of that depending on your work setting, but for the most part being a PA is about seeing patients quickly, taking care of their needs while being clinically sound, and getting all the other busywork done like charting, calls, more charting, orders, etc.

    Lots of PAs practice independently, but you are correct that we usually aren’t at the top of the decision-making hierarchy. But keep in mind that neither are many physicians. Not all MD/DOs are running their own show—they have chiefs and administrators to answer to as well. If someone is on the fence about being a PA, the grass is definitely not greener on the MD side.

    To be honest I think there is a reason most PA students and grads these days are women. It is better suited for them. They can shift their attention faster (aka multitasking), they are more patient with people issues, and they somewhat enjoy being “needed”. I know, I know—-“I’m not like that!”, or “Not all men/women are like that!”, but generally it is true. Just something to think about.

    The take-home message is this: If you aren’t really into patient care first and foremost, do not get into clinical medicine.

    • Paul March 24, 2014, 1:42 pm

      Some interesting comments, MM. While I agree with you that a person should consider this profession as one that works closely with patients and is in demand from many people on a regular basis, I don’t really agree with your comment that “PAs are generally pretty far removed from basic and clinical sciences.” I think it will depend heavily on your specialty, place of work, clinical population, and supervising physician. I make many (many, many) pretty serious clinical decisions in the course of my day. Maybe I’m lucky. But I work in urgent care and often my job is about identifying big problems before they happen. I watch my supervising physician working with the very same patients I see and making much the same types of decisions that I make.

      Do I use all that textbook science I had to learn in school during the course of my day? Of course not, and neither does my supervising physician. I can’t tell you much about cGMP or the complement cascade. But as you learn about medicine, these details become less crucial; you are aware of a bigger picture that is more relevant and you know what reference to turn to when you need to know what protein C3 activates in the complement cascade.

      If you want to work with patient, this is a great field. If you have particular needs for autonomy, clinical judgment, authority, severity of the patients you see, or complexity of the patients you see, this can still be the field for you. But if you become a PA and what some of those things above, you owe it to yourself not to take a specific job that doesn’t offer them. There are MANY options in medicine – it’s far too easy to make generalizations about the field based on what you are doing.

      Usually, my experience is that people are so glad to get into this field that once in it they think much about where to go next. They don’t consider their career trajectory, necessary skills, and settings. All of these variables change what you will be doing dramatically.

      So my advice: if you want to become a PA, then do. But CONTINUE TO THINK HARD ABOUT WHAT KIND OF A PA YOU WANT TO BECOME AND HOW YOU WILL MAKE THAT HAPPEN. There are plenty of crappy physician jobs about there. Heck, there are a few rockstar and astronaut jobs that suck a lot more than anyone knows. As I’ve said many times, it’s less about the field and more about you.

  • MM March 24, 2014, 3:55 pm

    I think perhaps more than any other direct healthcare provider profession, PAs have the most variability in their individual jobs and the demands/perks of their jobs. So it could be I just haven’t found my ‘niche’ yet in medicine. I’m certainly not giving up on the profession.

    That said though, I was a guy who got into medicine out of scientific and lifestyle interests, with patient care as an afterthought. Hence, I am not loving certain aspects of my job. I may be better suited for academics or something non-clinical, but that remains to be seen.

    Thanks for the follow up.

  • dnguyen March 26, 2014, 10:35 pm

    Hi Mr. Paul!
    I am a high school senior and let me just say I am fascinated by your articles! I have set my future to becoming a PA. I’m inspired by my family-most are in the medical fields and I have gone with them many times to work so I definitely have some idea to relate to your article. I just tend to get confused, there are so many ways to be a PA, do you have a say in what the right or most stable way (as in for sure on the way to be a PA) is?

    • Paul March 29, 2014, 7:39 pm

      If I understand your question correctly, you are wondering what is the surest way to become a PA?

      If I had a recipe, it would be:
      1) Get a bachelor’s degree with excellent grades in a medically relevant major
      2) Get EMT cert and begin working as one for at least 2 years
      3) Get into medic school and work as a medic for at least 2 years
      4) Apply with an inspiring and well written essay
      5) Go to PA school

      Incidentally, this path doesn’t pay badly once you become a medic. So it’s great experience, good money, and you’re in PA school by about age 26.

      • dnguyen March 30, 2014, 1:19 pm

        Nice. Thanks for the ‘recipe’!

  • Miranda May 21, 2014, 9:34 pm

    Hi Paul,
    I found your article and I was very inspired by it. I just graduated with a psychology major at the University of Michigan and I am taking some prerequisites before applying to PA school. I never really had a passion about any subject, and I took a wide variety of classes in every subject throughout college. I had surgery three times and was in contact with my PA and shadowed her for a summer. While observing the surgery I thought it was pretty cool to watch (I am not afraid of blood) however I never thought I could do it. I graduated my final semester with a 4.0, got an A in my biology and chemistry classes, however I just never saw myself going into the medical field at all. In fact, I never saw myself in any particular field. I have decided to do PA because i hear that it is a great profession and my family thinks I would be great at it. I loved the anatomy and physiology classes I have taken, and I loved the neuropsychology and cognitive psychology classes I have taken as well. I love working with people and I always said the one thing I know for sure is that I want a career path that is rewarding. I want to be able to see people improve and I want to make an impact on the lives of others. I am just worried that because I never saw myself becoming a doctor and never believed I would do anything with science, I will not succeed in this career. I am not saying I do not like science, I am just saying that I had never intended on a medical profession. I do have experience shadowing an orthopedic PA, a primary care PA and a cardiologist and I have volunteered at a hospital. When I talk to other PA’s all responses are that he/she always loved medicine, or always wanted to be a doctor, and realized that PA was for them. I wanted to know from you if you knew anyone who was the opposite. If you knew anyone who never thought about being in the medical field at all and then realized that PA was actually for them? I am open to all opinions. Thanks for your help!

    • Paul May 24, 2014, 11:11 am

      I don’t have personal knowledge, but I’m sure it happens. What makes me less concerned about you is that you have done some shadowing, so you should have a pretty good idea what you’re getting yourself into. If you like it while shadowing, you will probably like it from the practice end as well.

  • Joshua Katz June 5, 2014, 9:12 pm

    I’m considering PA school in the next few years. I’ve been a medic for 10 years, but for much of that time haven’t worked beyond the EMT level. I’m currently leaving my job as a high school teacher to split my time between starting a small business as an educational consultant and working per diem as a medic. I’ve also started prereq classes, beginning with organic. I’m still nervous about it, though – I want to understand the body and use my scientific knowledge, I want to work with sick patients with multiple comorbidities, I want to work with hard to diagnose cases, be called in for referrals, and practice with autonomy. Maybe PA isn’t for me?

    So, what I’m wondering is – does doing a residency help in gaining respect from supervising physicians, and thus autonomy? What attracts me to PA is the flexibility and not having to choose a specialty – I’m interested in critical care, but also in keeping a hand in the EMS world. I’m wondering if doing a residency in EM, with a strong EMS component, plus one in trauma/surgical critical care, would be a good route to go, and position me well for a variety of high-responsibility positions, as well as being able to work in critical care transport and providing medical control. One thing I’m very interested in is bringing PAs into the EMS world to treat the least sick (need an Rx, not a transport) and the most sick (need a chest tube or amputation in the field) patients.

    • Paul June 7, 2014, 10:44 am

      Hi, Joshua. I’ll put this simply:

      All that is great – it will make you very knowledgeable and qualified for different types of jobs. But don’t do it to gain more respect from anybody, least of all physicians. Nobody will know much about your training unless you offer it, and no one likes to be around anyone who always make a point of telling you about all their experiences and qualifications. The best reason to do the things you suggest is to secure a tough job in the field. Once you’re in that job, it will be your work and your attitude that qualifies you in the minds of the other providers and staff.

      • Joshua Katz June 7, 2014, 3:12 pm

        Thanks Paul. Do you believe, then, that a good PA, with a good cooperative attitude, a willingness to learn, and good experience, can end up practicing with a good amount of autonomy, and seeing hard to diagnose patients? Or is it simply the case that a PA will hit a ceiling and not be able to rise to the point of treating the most sick and most complex cases autonomously?

        Also, do you think there is a future for PAs in EMS and in critical care transport, flight and/or ground?

  • Madousar June 10, 2014, 10:22 pm

    Hi Paul
    With a B.S. in Biology (’95) and having taught Science and French in High School for more than 10 years, what are my chances of getting into PA school and doing well. I am 53, and I have a certain affinity for the medical field.

    • Paul June 20, 2014, 9:58 pm

      I usually steer a pretty wide berth from “what are my chances” questions. There are just too many factors. Besides, I don’t advocate proceeding down a path because you feel like you’re likely or unlikely to succeed. If it’s the path you want to go on, it’s worth the trip either way. You would be an older PA student, but there was a 53-year-old in my PA school class, so I know it can be done.

  • Bob S. June 23, 2014, 7:44 pm

    I am a 48 yr old medic with 28 years experience. Over the last year I have been considering PA school vs RN/NP school. Despite NPs having more autonomy, I prefer the medical model of a PA. My biggest concern is the likelihood of becoming employed at 52 ( I have science credits I have to retake.) I am most interested in emergency medicine or urgent care fields. I have been told employers wouldn’t be interested in training someone with such a short career span. I hope I have a good 15 years in me minimum.

    • Paul June 30, 2014, 7:36 pm

      I think that’s BS. Many PAs work for only a few years in any one job. With your work experience, you would be an asset to any practice, or even more so to an ER. Getting into PA school will be a little harder for you than if you were younger, but you have great experience, as I say. DON’T GO NP. NPs are awesome – total respect for them. But to become one you would need to get a bachelors in nursing AND a masters in nursing before you would be eligible for NP school. You don’t have time for that! Go PA and you will save yourself 4+ years of schooling!

  • Bernard kwamena Sayikah July 25, 2014, 7:59 am

    I just completed my Registered Nursing education(diploma) and wants to pursue BSc in PA next year God willing. My dream is to end up being an occupational physician! Can you help me discern which way to go?

    • Paul July 27, 2014, 9:50 am

      Hi Bernard! If what you really want is to become a physician, I hope you will not make the mistake of becoming a PA first. PA and MD are different in their educational paths are much different.

      PA schools do not want to admit applicants who want to become doctors. Instead, they want applicants who are totally 100% fired up about becoming physician assistants. PAs are not “baby doctors,” or physicians in training. They are very capable licensed healthcare professionals in their own right.

      I suggest you research both professions carefully and decide which one you want to be in.

  • Lydia August 6, 2014, 10:57 am

    Hi, I’m going to be a junior in college. I was debating my future plan between a researcher with PhD and a PA. I’m now working in a lab as an intern and now I see that research is not for me. People can spend many years looking for one thing. I do want to become a PA because of the clinical setting, interactions with patients, and doing surgeries.
    However, one thing I worry about is that if I become a PA, I would have nothing to do If I see somebody sick with certain diseases that have no treatment. But if I was to be a scientist, there’s no guarantee that I could find some treatments for them either, and spend tons of time on it.
    I want to be a PA but I still have the passion for discovering new treatments for some diseases, may I get some suggestions from you?

    • Paul August 9, 2014, 12:02 pm

      Discovering new treatments is a very different thing than ordering/prescribing/delivering them. If you want to discover new treatments, you would be better off in research, such as for a pharmaceutical company. To your point about diseases without a cure, PAs need to help those patients manage their symptoms, which can be very complicated and rewarding. There are SOME PAs who do clinical research, but not many, so you shouldn’t count on doing that if you go into PA.

  • Carlo August 7, 2014, 9:15 am

    Hi Paul,
    Thank you for this great article. It gave me the push I need to become a PA. I am in the upper 40’s age range. I have a MPH, over a decade of medical military experience (ACLS, PALS, Infection Control, medical counseling, etc). I’m still shadowing a PA and a MD for over 2 years now (more than 2500 hours combined), seeing patients, doing medical histories, vital signs, providing medical education, among other things. I also have a foreign medical degree (MD), which I earned over 20 years ago overseas. Even though I passed the medical boards (not with the highest scores), I was never able to get any matching or interview to secure a residency. So, after considering this option for over 2 years, I decided to go the PA path. I just want to be able to take care of patients. I love talking to them, explaining things, advising them on medical issues. I really don’t care about the title next to my name. I am very confident of what I know and how to transmit this knowledge to my patients in order for them to feel satisfied with the care they get. I just hope that after finishing my prerq, I get accepted in to the PA program. So far, I have beeing conditionally accepted into this program, upon successful completion of the prerq. Do you think that being an IMG (international medical graduate) could work against me during the final acceptance committee decision? Should I mention that on my essay when I apply to PA school? Thank you for your advice.

    • Paul August 10, 2014, 9:54 am

      Carlo! I’m so pleased that you have come to this decision over time. I’m also glad that our article helped you come to it!.
      I don’t think being a FMG will hurt you. I’m torn about mentioning it in your essay. It would be a big thing to leave out, but people have all kinds of (sometimes inaccurate) ideas of why people don’t match. In the end, I think it will come down to how you describe what happened. We do offer essay coaching, so if you need help with that potentially tricky part of your essay, do let us know.

  • Carlo Coello August 10, 2014, 11:32 am

    Thank you Paul for your insight. I’ll keep you posted on any developments regarding my journey.

  • wes October 15, 2014, 3:46 pm

    I am in an interesting situation. I went and got my associates of science degree right after high school,thinking I was gonna be a psychologist. randomly decided to go to hair school, did hair for 5 years, killed my back standing in one place all day and knew there wasn’t a good future for me where I was. I am currently doing sales, doing OK at it, but I hate the stress of commission only sales since I have a wife and two young kids. Now I am looking at going back to school, trying to decide on a career. I love people. I love helping people. Psychology is still a little tempting, but it’s soooo much school, and not great chances at landing a stable great paying job out of school. Which after working sales, is the biggest thing I want is a stable income with a degree I know will be able to support my family. PA is sounding very tempting to me because of the job market, short schooling (I’m 28) and good pay. My problem is I have never worked or volunteered in the medical field and don’t really have a lot of time while supporting my family to go shadow someone. And in all honesty, have no desire to work as a cna or emt. I believe I would love to work in family practice simply because I am good with people. I would be EXCEPTIONAL at helping people feel at ease and help them not be scared. And EXCEPTIONAL at explaining things to people to help them understand what is happening and how to prevent further problems. But this is the first time I have seriously considered the medical field, because I don’t like the body fluids, blood and guts aspect of it all, I’m not the type to pass out or anything, just don’t enjoy it much.
    To sum it all up, I would love the stability of this career. I would love helping people, but I don’t know if the medical field is for me. If I could go straight through school into a family clinic, I think I would love it. But the idea of having to work as a emt, or something of that nature to get experience first does not sound like something I would enjoy at all.
    So… how to know if the medical field is right for me when I am too busy supporting my family to go shadow some one for a decent amount of time?
    And, how do I get past having no desire to work any of the jobs that get me the experience I need to go to school?

    • Paul November 2, 2014, 2:18 pm

      You are in an interesting situation. Medicine is not for some people. Since you don’t like blood and guts or the types of things that you would be doing as an EMT or CNA, you should know that in medicine, as in life, there is no free lunch. That said, a career as a PA will offer you a trade.

      First, the DOWNSIDE if you choose Primary Care. Some of your time will involve talking about, touching, smelling, and caring about peoples’ stool, urine, blood, pus, feet, bottoms, bad breath, penises & vaginas, wounds, dandruff, fungal infections, colostomy bags, urinary catheters, body odor, “toe jam,” mucus, and items lodged in the rectum/vagina/penis (more on those in a forthcoming article because I know you can’t wait!)

      The UPSIDE of the deal is that you get to do amazing non-yucky things like change the way your patients live, not kill themselves, feel better, have better relationships, understand how precious their health is, and yes, you will actually save lives. And if you are good, you will do it all for high pay and praise. If that trade off doesn’t sound good to you, then Primary Care (and maybe medicine) probably isn’t for you.

      But before you despair, know that many books have been written about people in medicine who don’t like touching patients (click to see one) and often those people enjoy medical careers in the No Patient Care (NPC) specialties. They include psychiatry, radiology, pathology, and a few others.

      At the very least, you MUST shadow. It will tell you if you can do this work or not. Do yourself a favor and shadow several people (docs, PAs, NPs, whatever) in different specialties and different settings (hospital/clinic/other). You might find that you can stomach some of the things you don’t like if they are 1) temporary and 2) aimed at eventually getting you into an area that you DO like. Being squeamish about blood, for example, is not mission-critical.

      With all that said, it is your last sentence that concerns me the most. “How to I get past having no desire to work any of the jobs that get me the experience I need to go to school?” Changing careers involves risk. I worry about someone who wants this career, but doesn’t want to sacrifice the time, money, energy, and comfort to do what it takes to make the leap. If that really is you, forget about lunch — medicine won’t even get you a free refill on your soda.

  • Danni November 12, 2014, 12:09 am

    Hi Paul,
    I just wanted to start off by saying thank you for writing an article on why *not* to be a PA ( it’s just nice to hear another perspective once in a while.) I just have a few questions about becoming a PA. I’m a senior in high school, about to send off my college apps and I am the type of person who likes to know what she is doing. I am currently deciding between becoming an MD and a PA for the usual reasons of life quality( I want to have kids, a husband, time off etc…) ,pay, debt, etc… and my uncertainty is making me rather nervous. I know I am young and have time to decide but here is my actual question: What made you want to become a PA/would you ever consider being a doctor? and how did you complete your required medical experience hours that I keep hearing all about?(like did you become an EMT or volunteer or something else? Any response is greatly appreciated. Keep up the good work!

    • Paul November 30, 2014, 8:13 pm

      Hi, Danni! Thanks for the compliment.

      Yes, you have time to decide, but that doesn’t mean that you shouldn’t start thinking about it now. I became a PA for several reasons, but the biggest was about where I was in my life. I was married and settled with three small kids. I knew what medical school would do to my family (ask a medical student — it’s absolutely brutal). 4 years of hard, hard study, during which I would see little of my family and miss some of the best years of their childhood. Then 1 year of low paying, many-hours-per-day internship, and 3-6 (depending on specialty) of residency, making only a little more. In the end I would make more money, but in a job that would demand more of my time than I was comfortable giving up. So yes, at a point I definitely considered medical school.
      But for me, it just didn’t make sense. Since I’ve made that choice, I’ve never regretted it. I get to do all the things I love in medicine, make good money, and have enough time to have kids and this website.

      Since I came to the field later, I had another career on my resume (I was and still am a licensed Marriage and Family Therapist). I sold this as good experience with patients because it was. I had worked in my own private psychotherapy practice, and as a therapist in a psychiatric emergency doing a lot of assessment with people who were in crisis. I also had experience hours as an EMT, so if they had any doubts about my *true* medical experience as a therapist, that took care of those. I worked as an EMT for about 3 years and accumulated several thousand hours of time with patients.

      Don’t rush it. You’re young and the health care experience requirement is there to make sure that when the time comes, you will be ready to learn what PA school teaches. You will also be more prepared because you will have plenty of experience talking with patients from before PA school.

      Keep me up to date on your progress, okay?


      • Danni November 30, 2014, 8:48 pm

        I definitely will! Than, you for the insight 🙂

      • Danni November 30, 2014, 8:48 pm

        I definitely will! Thank you for the insight 🙂

  • woot January 17, 2015, 5:40 pm

    First, Paul, I think this website is a great resource for people considering or aspiring to be PA’s. It has changed my opinion about what they are capable of doing and being. One of my concerns, is the ability to do international health work. Because PA is a U.S.-only profession (as is Nurse Practitioner), how does this affect those of us who want to work abroad, in countries that don’t recognize the PA degree or profession?

  • Lauren May 28, 2015, 11:35 am

    I just graduated college, and I have been on the pre-med track the whole time. It wasn’t until the end of my junior year that I wanted to look elsewhere. I got so fed up with studying for the MCAT, and it really de-railed me. (I did not end up taking it).

    I discovered PA, and the profession seems great. However, I am still going back and forth between PA and medical school. I have over a 3.8 GPA, and I have a lot of volunteer experience. However, I do not have clinical hours yet. Will that put me at a disadvantage for PA school? I am starting a patient care tech job in June, so hopefully that will give me some great experience.

    I am really torn, because both seem like great professions.

  • adisu July 4, 2015, 7:37 pm

    Hi Paul
    Medical field is my passionate and my heart is always there. However, I ended up in plant sciences due long and complicated reasons. I am 37, one kind and wife. Thinking really hard to consider PA. My problem is zero medical experience and zero prerequisite classes except chemistry and microbiology. Do I need to take all the prerequisites before I ever consider applying? Are online classes acceptable? I have no issue with studying longer hours or touching/helping people.

    • Paul July 20, 2015, 4:18 pm

      Adisu — You will need to take most of them. The majority of schools will allow you to have 1 or 2 courses in progress, but that’s usually about it. So you do have your work ahead of you. But it will be fun work (IMHO).
      Community college courses are perfectly acceptable. The challenging part will be taking courses while you try to accumulate HCE. You can do them both at the same time, but DON’T let your patient care work get in the way of your studies. If you get low grades, you will have shot yourself in the foot (head).

  • Marissa Stevens November 1, 2015, 9:02 am

    I am a high school student seriously looking into a career as a Physician’s Assistant; however, reading this has given me some concerns. I will admit that I am a Science based person and love that part of medicine, but I also equally enjoy working with people and trying to help them as a person and not just another problem to solve. I am hoping for a career that balances the science aspects of medicine with the social aspects. In your opinion, should I look into a different career?

    • Paul November 8, 2015, 11:08 am

      I think PA is the perfect balance of science and interpersonal work. That said, everyone’s balance point is different. This job never gets old. The people part is satisfying almost immediately. The medicine takes time to learn and be good at, just as it does for MDs. But from what you’ve shared, I suggest that you find a PA you might shadow so you’ll know even more clearly if this is right for you.

  • Kajal November 23, 2015, 11:21 am

    Hi, I’m currently a high school student wanting to pursue a career in medicine/health because I want to help people. I’m stuck between wanting to study to become a PA and a Dietitians. Any suggestions to make my decision easier?

    • Paul January 18, 2016, 11:21 am

      I suggest that you spend at least a day shadowing a dietitian and a PA. Maybe do it a few times with different dietitians and PAs. After that, it should be very clear what each does and how well those careers fit you. Never discount the importance of immersing yourself in your decision as much as you can BEFORE you actually make the decision.

  • Dylan January 3, 2016, 9:34 pm

    I feel like I really love medicine and science, but I’m not a people person. So I don’t want to go to med school to become a doctor (or a PA or nurse for that matter). I’m majoring in Biology with a concentration in human biology. I don’t want to go to med school because I really do not want to work with patients (at least I’m pretty sure, I haven’t shadowed doctors or anything). I have Asperger’s so I’m living with my parents, which is normal for someone like me. I do stutter sometimes, so there’s that. I’m not interested in the clinical side of medicine (patient interactions?) but rather the research side.

    The OP in this thread describes me well:

    The thing is, I would probably love to learn the material that MDs learn, at least the curriculum of the initial four years of medical school (excluding residencies, etc.) but I just couldn’t see myself working with patients. I’m more interested in the science side of medicine (anatomy, physiology, etc.) then taking a patient’s history and all that jazz. There is the PhD in biomedical science, or the MD/PhD program, but I’m unsure of those right now. It’s going to be about 5 more years until I graduate, so it’s not like I have to decide any of this right now. I just would like some advice or career options for someone like me. I do plan on doing undergraduate research since I’m only doing a single major (I can’t double major because I’m very slow at learning and it would take too long; I think employers value doing well in one field anyway (high grades, research, graduate classes) over learning a good amount about two subjects without mastering them) I’ve seen one YouTube video where a med student said that med school is like a semester (16 weeks) condensed into five weeks. Supposedly it’s like taking 21 credit hours of science classes at once. Since I’m very slow at learning, I know couldn’t go to med school even if I wanted to. After reading posts by medical students, I think she’s right: it’s insane how much you have to learn.

    I’ve discovered Medical Laboratory Science, which looks awesome. It’s something I’m really considering; I might work as a lab tech then maybe get a BS in MLS, who knows. I’ve always felt drawn to research, so MLS is definitely something I’m looking forward to if I pursue it. (Hope I didn’t answer my own question :))

    Do doctors, PAs and nurses mostly just take care of patients? Do PAs do any lab research? What do you think? Thanks in advance. I would just prefer to be a PA over a doctor (if at all) due to the debt and time commitment.

    • Paul January 18, 2016, 9:43 am

      Hey, Dylan — I’m sorry it took so long to get this answered. I think you’re on the right track. PAs and MD mostlywork with patients. There is a great book that discusses people who graduate from medical school and don’t like patients. It’s a novel, and it’s a classic, a very fun read, and it invites some interesting opinions. I wrote a post that talked about it a while back that you can read by clicking here.
      That said, I think you’re much more likely to find career satisfaction as something other than a PA or an MD. Their primary mandate is to produce clinicians who work with and care about people, even if the two professions go about it somewhat differently. Clinical laboratory science is much more likely to satisfy you, as are some of the graduate level careers in the biological sciences and chemistry. These are what as children we thought of as “scientists.” People who have advanced science training, and who live to ask and answer their own questions about that science. The essential qualities for those fields are 1) good academics with regard to the sciences, 2) strong logical ability, and 3) insatiable curiosity (probably the most important factor). Many of these professionals work in a lab designing and performing experimental studies to expand our knowledge of the sciences. Most of our current knowledge of medicine comes from a textbook that comes straight from these folks. To generalize hugely, they are often chided for being smart, technically proficient, interpersonally “distant,” and isolative. Obviously, they still in most cases need to interact with people, but far less than PAs and MDs. If clinical lab science works for you great. But you’ve said you have an eye for research. Why not get a masters/PhD in a science that interests you, study under a skilled researcher, and eventually contribute to that body of knowledge as a researcher yourself? I did rat research in college and I hated it. My supervisor was a phychologist who was a huge nerd and loved nothing more than being by himself in a lab and figuring out things like “is there a part of the rat brain that allows rats to learn based on internal states like whether they have been fed or not, and if so, can it be manipulated?” (It turns out there is — it’s the hippocampus, and his research pretty much confirmed it). Anyway, you might find a home in that kind of environment. Obviously, every “scientist” is different. Some are very social. But on the whole, your strengths would be well outweighed by your dislike of working with people in such an environment. Anyway, let me know how it goes…

  • Dylan January 18, 2016, 4:05 pm

    Thanks for the reply! Sorry, I didn’t mean to complain; people are busy, they have work to do. I’ll definitely take your advice to heart. Much appreciated. 🙂


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