Practicing PA making the switch to MD

Hey guys! Just stumbled across this forum. Happy to see there are other nontrads getting back on the horse too :slight_smile: I have a few logistical questions I hope y’all could help me with.

Background: I’m currently a practicing PA in EM/ICU for ~4 yrs looking to make the switch to medical school for a number of reasons which I’m happy to elaborate on if needed. Three kids with a work-from-home home husband. Undergrad major chemistry with cGPA 4.0 and PA grad school GPA also 4.0. All med school pre-reqs essentially met via PA school pre-reqs. Haven’t taken the MCAT yet but started studying and plan to take it in the next 1-2 years.


  1. Would it be more financially wise for me to work an extra 3-4 years, pay off debt and save up for cost of living with my PA salary before applying to/starting medical school? Or would it be better to start sooner rather than later, let the debt build unholy amounts of interest throughout med school + residency (and have med school debt added on top of that) knowing that I’ll be making more money sooner?

  2. Are there any legal issues/conflicts of interest against me picking up shifts as a PA while in medical school? Or working during med school in general? Do people do this?

  3. Do I really need to obtain shadowing hours given my experience practicing medicine…every day?

  4. Should I be going back to school JUST so I can get science LORs? Or would it be sufficient to obtain LORs from my physician colleagues and PA faculty members?

    Sorry if these have been asked before – thanks so much for the input!
  1. Not sure about how those numbers would work out. Starting school debt free is nice because you don’t have to worry about the extra cash outflow when you’re taking the hit from making good money to making no money. Maybe someone with a stronger accounting background could comment on the actual financial feasibility.

  2. No PAs in my class, but a PharmD did get his license transferred over so that he could theoretically practice. He said there were some gray areas when it comes to what he could and could not do depending on what capacity he was working under (ie in “student mode” he can’t technically use any of the privileges). The only person I know of in my class that works at all does a part time barista gig on the weekends. Since you already have a decent background in a lot of the basic sciency stuff, you might have more time on your hands than the zero experience med student.

  3. You’re probably good. You will definitely get some questions about why you want to switch, why you want to switch now, and why you didn’t go to med school initially. Normally you shadow to see what it’s like as a doc beyond the frills on gray’s anatomy or whatever. You’ve probably got a pretty good understanding… Might be worth asking schools to see what they want. Only a few actually make shadowing a written requirement.

  4. Depends on what schools you want to apply to. Only one school that I requested an LOR waiver from since I’d been out of the physical classroom for 10 years said no. Some schools have caveats already planned for for students that have been out of formal schooling for awhile. Some will want you to reach out to teachers who definitely won’t remember you. Easy button is to not apply to those schools. I got LORs from supervisors and docs I shadowed. Your plan is probably sufficient.

PA here as well applying this summer… did you find out any more about the LORs? How much working time do you think is feasible during the first 2 years of med school?