Hi! I’m a sophomore at a Top 20 school halfway towards a Bachelor’s degree. I’m taking the premed requirements but I’m still not 100% certain that’s what I want. I’ve done a small amount of shadowing with a PCP at his private practice, and two RNs in the NICU and Pulmonary Units at a large pediatric hospital. But I don’t think I was there long enough to develop any strong convictions about these careers. And the more research I do, the more all the job descriptions kind of mix together, and I don’t know what I really want at this point.
So, here are some specific questions:
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[]Autonomy - I know that it’s generally MD > NP > PA > RN. I am a pretty independent person, but I don’t have a problem with following others’ orders and instructions either. Why do the people who want more autonomy want it? Is it just a personality type thing?
[]Generalist vs. Specialist - MD / (generally) NP are specialists, and PA / RN are generalists, yes? I like the idea of having a lot of experience / expertise in a certain field, but I’ve also never had to work in any place for so long. I’m interested in primary care / specialized pediatrics, and specifically neonatology; do those fields have enough variability to be interesting, or is it generally the same few things? And how much could a PA do in different fields with less education than an MD?
[li]Education Model - What would be the difference in thought process for diagnosing / treating an NP vs. a PA when seeing a patient?[/li][/ul]
Differences that don’t (I don’t think) matter as much to me - Education time (although less debt + my Bachelor’s in not-Nursing being useful would be nice), salary, work hours (I have no idea how my life is going to look later on, not so interested in marriage / kids), prestige (well, maybe a little, but I’m not going to let it keep me from a good fit)
About PA’s: They specialize and work in a variety of settings.There are PA’s serving in just about every field of medicine. In some specialties they do intake and follow-up, or assist in surgery. My daughter works in a family practice setting and does everything that a doctor would do, and is virtually autonomous (by law the doctor has to review a few of her charts every month, but that is the extent of his supervision). She operates the clinic alone with her nurse when the doctor takes frequent vacations, sometimes 2 weeks at a time. Sometimes she consults with him about cases; sometimes she has picked up conditions of his patients that he has missed.
She is thinking about specializing at some point, which would mean taking a short course or two if necessary, or the specialist would train her (the cardiologist that she did a college rotation with is begging her to come work with him). PA’s take licensing exams every few years on ALL aspects of medical care, unlike doctors who recertify for their own speciaties, so switching fields is easier for PA’s.
It may be easier for you to get into Med School than into PA school; most PA’s get into the grad phase through 3+2 college programs. You would need to check now to see if you are on track for getting the required undergrad courses taken, and have to have 3-5000 hours of patient contact hours documented before entering a PA program.
With regard to medicine, I think it’s more about the intellectual effort you want to commit to in the process. RN’s don’t diagnose people or come up with treatment plans, PAs and NPs can only do that for the simpler, more common cases. MDs get much greater intellectual challenges.
The MD will always give you more freedom. You can do just a pediatrics residency and be a general practice pediatrician (either in patient or out patient), or you could do fellowships and sub specialize. The doors definitely close more (or are harder to open) with the other degrees. Maybe @kristin5792 can talk about pediatrics since she just matched into it - if she doesn’t come to talk about it I’ll share what I can but she’ll know way more than I do.
I don’t know that the process is really any different - just the depth and breadth of knowledge.
@iwannabe_Brown I’d never thought of the intellectual effort piece of it; that’s a really good point! Also, I know that MDs and RNs can do research, teach, be involved with policy or public health, etc. on the side, Is this also possible for PAs and NPs?