PA Vs. MD: if you’re in PA school, are you a medical student? Part II

Posted By: Paul   |   PA vs MD   |   7 Comments

Finals are over - finally - and I can now look at the results of my unofficial survey asking the PA vs MD* question: “Are those in PA school Medical Students? If you missed the post, you can read it by clicking the link, or you can read the article on KevinMD by clicking here. Basically, I wrote an article about my first experience performing a pelvic exam for KevinMD, and a reader didn’t like that I referred to myself as a medical student. So I started a poll here at IPAT to see what readers thought.

When I asked my classmates about the issue, I was surprised at how differently we all saw it. It would have been easy to react to this and get defensive, but I decided instead to “put myself out there” by raising it as a topic here for IPAT readers. Grist for the mill, as they say in my former career as a psychotherapist.

Poll Results

What our readers thought

After over a hundred responses, the results indicate that people are essentially divided on the issue. Here’s a little context for the discussion:

• My original article was entitled, “My First Real Patient.” Kevin Pho (owner of KevinMD.com) retitled it to “Pelvic Exam by Medical Student for the First Time.” This was his choice, and I didn’t know about it in advance.
• In the article, I referred to myself as a medical student. I haven’t shared my rationale so far, because I didn’t want to contaminate the survey. My reason for calling myself a medical student was twofold:
  • In a piece limited to 500 words, extraneous details risk confusing the reader, and I felt that to keep things simple, I would use a term that was got the message across without a ton of explanation. The experience seemed the important part to me, not my title or degree.
  • I study medicine, and when I need to tell people about my education but don’t have much time to go into details, I use the term medical student. I have no interest in misleading the public about what I do. I definitely wouldn’t spent the kind of time that I do writing this blog if I didn’t feel so pumped about my choice to become a PA and not an MD! And yes, it was a choice.
• I placed a link to the poll, so that readers of the KevinMD article comments thread could vote too.
• The various arguments that I’ve read in favor of calling those in PA school medical students include:
  • They study medicine, so what’s all the fuss? Architects and contractor study building design, but that doesn’t mean they are the same thing.
  • People often don’t know much what a PA does. Many patients continue to call their PA “doctor,” even after the issue is addressed. At some point, you just need to let it go. Are you going to correct them every time you see them?
  • It’s a shorthand; if clarification is necessary, you can provide it (immediately)
  • PAs are becoming better recognized, and the public needs to know that their training is much closer to that of doctors than to that of medical assistants or nurses, or Certified Nursing Assistants (CNAs).
• Arguments on the other side include:
  • It’s misleading, making people think that you are working toward your MD. You should be very specific so there is no confusion.
  • Calling yourself a medical student doesn’t do justice to the longer and different training that traditional medical students do
  • Calling yourself a medical student doesn’t respect the PA profession.
  • Would you say call everyone who studies medicine a medical student? What about Phlebotomists? Anatomists? Dentists?

My take, with hindsight

I can see how some people have a problem with the use of the term. I think that, as in law, one’s motivation is relevant to the issue; if you’re using a term it to impress someone, to get laid, or because you wish you were an MD and not a PA, you’re making a mistake.

My classmate and friend, Sundance (who has also been a traditional medical student at UC Davis) made the point that PAs lose credibility with the public when they hold themselves up to be just like doctors, or as something they aren’t. I might amend this a little: PAs lose credibility when others perceive them to be misrepresenting themselves. It’s a small difference, but an important one to me. I can’t totally control how others see me, and if anyone was mislead by what I wrote, it was unintentional.

One reader summed up my feelings nicely: hopefully someday the public will have more familiarity with the PA profession, and when they hear that you are a medical student, they will add, “Really? MD, or PA?” Until that time, we should be thoughtful about how we describe ourselves, and be prepared to clarify when there is a misunderstanding.

Would I do it differently if it happened again, the same way? I don’t think so. Will I consider carefully which words I use each and every time that an issue like this comes up? Definitely. -P

* PA Vs. MD is not meant to indicate any animosity or even competition between PAs and MDs. It’s a category of discussion that pops up from time to time at Inside PA Training - how the two fields are alike, different, and how people make decisions about which one is right for them.