Non-Traditional Physician Assistant (PA) Strategy


I’ve searched the forum, and since I didn’t find a discussion, I thought I would start one here. I’m new to OPM, presently a full-time working professional considering going back to school for pre-med studies. Presently developing a plan to either quit and go back to school full-time in a formal post-bacc at a 4-year university, or attend evening community college classes at the CC nearby. I’m leaning toward pursuing the Physician Assistant (PA) route vice the MD route. Is anyone else on this forum looking at PA school? If so, if farther along, how did you obtain the health care experience hours (HCE) required if you were also working full-time? I presently work in Finance and get paid well. Consequently, taking a $10/hour EMT job for a few years seems kind of crazy. Ultimately, though, I want to change paths. Anyone make a switch from the business world to the PA world? What was your strategy?

  • Many of the PA schools require 2,000 hours of health care experience, shadowing PAs and Doctors etc. Looking to brainstorm with everyone on the most effective path to PA school while also being a working professional. Hope this post makes sense and is useful to the community.

MD student here, but PA school was something I considered. Part of what ruled it out for me was those health care experience hours. In order to obtain those hours in a reasonable amount of time, I would have had to quit a good-paying job for about a year or so to work for near minimum-wage. It was either that, or work every weekend for several years. When I considered that against one more year of school, it made more sense to me to spend 4 years in MD school versus 2.5 in PA school, plus one year or more fulfilling the reqs. With the time commitment being roughly similar, MD was more appealing.

I have several friends who have gone the PA route, and most of them worked either as EMTs, or as nursing assistants (certified or not). The majority of them either worked part-time in their health care role while they were taking their pre-req courses, or worked full-time in that role until they got the necessary contact hours.

Thank you for the fantastic advice, Bennard. This was a perspective that I had not fully considered. I’m not yet keen on the 80 hour workweeks during residency. The four years for medical school compared to a similar amount of time for a PA makes sense, but then thinking about adding on another 5-7 years of grueling residency…I start to wonder. This is probably a personal thing that someone can only answer for oneself. Are the additional years of residency worth it?

You’re right, it’s a personal thing that you need to consider regarding residency. Depending on what you want to do, residency can be 3 years (IM, EM, Peds, etc), or it could be 5+ years (surgery, surgical subspecialties, medicine subspecialties). Some residencies are more grueling than others.

Personally, my perspective is during that time, while I’m technically in training, I’m going to work everyday being a doctor, which is my goal. The only downside is that I won’t be compensated like I’m a doctor during that period. Also, for me, I’m more interested in the shorter residency paths. It would change the calculus somewhat if I was going to have longer than a 3-year residency.

You are not a non-traditional PA, rather you are actually traditional, historically speaking.

I thought long and hard about the PA path, and was accepted for 5 interviews. Here is what I took away from my experiences in that horse race:

  1. PAs typically work the same or longer than their supervising physicians and earn roughly 1/3 of their pay.
  2. Lateral career moves are becoming a thing of the past; residencies are the new future.
  3. The terminal degree is creeping toward a doctorate (more school, more tuition).
  4. Lobbying from higher level PA admin is nearly non-existent. NPs are out practicing independently and PAs are still called “assistant.”
  5. The average PA school is as/more competitive than top ranked med schools. For the middle-of-the-rung schools at which I interviewed, the average rate of acceptance from total applications received was a whopping 3.4%. That, my friend, is what Mayo and Harvard take for their MD classes.
  6. The average stats of the average student are outrageous and comparable to stats for incoming students to low-middle tier med schools. Many, like myself, have hard science degrees with all the pre-med pre-reqs and a 3.5+.
  7. Tuition tends to average right what a comparable medical school (ranking, state) would charge. Expect to walk away with nearly 150K+ in tuition/book/supply debt for two years of education.
  8. The world’s largest employer of PAs - the VA - tends to use PAs in more of a supporting role and tends to favor NPs for more autonomous roles like PCP, cardiology, etc.

    Basically, unless you are a middle-aged career changer, then there is, in my opinion, no reason to not just pursue medical school.

    All in all, I would highly recommend spending time talking more with those who are currently in the profession for a good outlook on what it means to become a PA these days. try - you can find me there as “Glorious_Ignoramus”.

    Best of luck to you.

Thanks so much, Jfowler85! Do you mind telling me a bit about your background that led to your advice? Just trying to get some context for your comments. Are you currently a PA-C, or going to school to be a PA? Or are you an MD/DO, or going to school to be an MD/DO? I read a number of your comments on and could not tell.

I bit more about me: I’m 32, single, no kids. I’m a bit bored with my corporate job in Finance/Project Management. I actually work for the Federal Government, so have good stability and decent benefits (insurance, time off, good hours). My work keeps me limited to the Washington DC metro area. Making about $95K per year. Financially, it doesn’t look like a will make a ton more as a PA. However, there are more opportunities to work for two clinics at once, or moonlight somewhere for the extra cash. My corporate work is a straight salary, with no market outside the standard workweek. 32 years old does not seem too late to start the MD path. I’ve been looking at a few post-bacc programs. If I can muster the courage, I would quit my job and go back to school full time. My education is a B.S. in Business Administration (4.0) and an MBA in Finance (4.0).

Would you mind expanding on a couple points you made (numbered accordingly):

  1. Both PAs I know have great worklife balance. One is a Cardio Thoracic PA and the other is an Emergency PA. Both basically work 4 10’s. The emergency PA gets overtime for anything over 36 hours per week! She’s 27 and making $120K working 4 days per week. Would you say she is an anomaly? I’m just too inexperienced in this world to know the work/life balance of a PA at this point. I plan to shadow more.

  2. I did hear that PA school was more competitive than Medical school, but wasn’t sure if that was a rumor. Do you know of a reliable source for this? This is a big one in my decision process.

  3. Ultimately, can one conclude that a person could get into a top tier medical school instead of a middle-tier PA school, given the same stats/credentials?

    Again, thank you so much for your perspective. I’m giving medical school more serious consideration instead of the PA route.

WonderingWhatIf, thanks for this post! I’m curious what path you ended up pursuing…

I am facing a not-entirely dissimilar situation myself as an OPM (31 y.o.) coming from a well-paying job but without a lot of healthcare experience.

As a happily single minimalist with no kids, I care little for the financial implications of my decision so long as the work-life balance is commensurate to the compensation. For example, I don’t want to take on a role (as described by Jfowler85) whereby the work-life balance is similar but the pay is fractional. Likewise, I don’t want to spend 1-2 years preparing to become competitive for PA school, and still fail to get in while my time could have been similarly/better spent preparing for MD school.

Recently I’ve read reports of 90%+ job satisfaction for PAs and an average of 42 hrs per work-week. That sounds pretty darn good to me - especially given the shorter educational track, less administrative headaches, and more contact time with patients.

Anyway, I’m going to toss up my own thread on this topic, but thanks again for yours and if you’re still getting updates I’d love to hear how your decision turned out!