 Doctors are rich. That's a stereotype that's been around for a long time and it kind of does hold true. Doctors get paid a ton compared to the average worker in the United States at the very least. Different countries, this obviously changes quite a bit but everything I'm talking about today is about the United States. Of course, there's also nurse practitioners, physician assistants and all kinds of other health careers that do pay quite well. But usually physicians are the top dogs, especially surgeons and specialty physicians. Me personally, I'm a physician assistant and so today I'm gonna talk a little bit about the financial side of working as a physician assistant versus working as a physician. And in particular, today's video is called Physician Assistant PA versus Doctor MD. Who can get rich the fastest? So it should be a no-brainer. Doctors make a whole lot more than physician assistants so naturally they would get rich a lot faster, right? Maybe, maybe not. Most of that is because of the length of training for a physician. A physician has to do four years of undergrad, then four years of grad school, which is medical school, and then almost always they have to do at the very least three years of residency and for specialty and especially surgical specialties that can be from five to as long as seven more years. And then if they have to do a fellowship, they have to do other kinds of training that could be another one to two years. So physicians can actually, especially for the really high-earning positions, can actually spend 10 or more years in school, in training, whereas physician assistants, we do our undergrad and then two to two and a half, maybe three years max for physician assistant program, and that's it, we're done out making at least 100 grand or so, sometimes a whole lot more. So does that difference in time account for the difference in salary, especially given things like investments, compound interest and all of that? Can't a physician assistant making a whole lot less than a doctor but spending a whole lot less time and training and a whole lot more time because of that making money, can we get ahead into a point where a physician will have a difficult time catching up? Is that possible? Today in this video, I'm gonna find out, I'm gonna do some very basic math and we'll see what pays better over the long term, a PA or a doctor. All right guys, and like I said earlier, I'm a physician assistant, my name is Boris. I've been practicing for about one year and I work in primary care and medically supervised weight loss. But without further ado, let's get into this video. So I'm gonna share my screen and this is just a simple spreadsheet and now I'm also gonna pull up my resources. And so these are the sources that I'm using, whether you trust them or not, it's up to you. But yeah, let's use these resources. I'm also gonna of course make some assumptions just to make this video a little bit more simple. And so let me share the assumptions that I'm gonna make with you. So first assumption, I am comparing a primary care PA such as myself to a primary care doctor. That is gonna be the easiest comparison, kind of like apples to apples or I don't know, I guess apples to oranges, doctor versus PA, but working in the same specialty. As opposed to a specialist such as like a spine surgeon who makes like half a million or more, usually starting out after a fellowship or even a PA working in cardiothoracic surgery, a very high speed dermatology PA who's had a lot of experience and really gets a lot of RVUs that they can make $200, $200 plus $1,000 a year. So I think those like super rare, super specialist kind of practitioners are not as fair to compare and not as easy to compare as it would be for say a primary care PA and a primary care physician. So that's the first assumption. If that doesn't suit you, of course, turn off the video but don't forget to like and subscribe. But so today, check this out. So the average physician assistant based on the 2022, of course, this is for the previous year. So 2021, AAPA, American Association for Physician Assistance Salary Report. And this is basically aggregate data for as many physician assistants as possible. I think almost every physician assistant is a member of this organization. So the data pool is actually pretty big. So it's actually quite accurate. And the median, not the mean, but the median compensation for 2021 was $115,000 a year. Having worked myself in primary care and also gotten multiple job offers, just doing my own research, basically, I wanna know that I'm paid fairly. I'm gonna say that this is basically pretty accurate for most primary care PAs, at least especially early in their career until they have a very large patient pool and they get a lot better and more efficient at doing their job. So I'd say about 115,000 is probably pretty fair. So just before we forget, could have got no short-term memory whatsoever, especially after working a long day like I did today. Let's do this. So PA, MD. PA, $115,000 a year. Now let's go back to our resources. All right, so there's that. Now, based on weatherbyhealthcare.com, hopefully this is accurate, they say that a primary care physician in 2021 was average, on average, compensated $260,000 right here, $260,000 a year in 2021. As you can see, if you read a little bit further, average compensation for specialists was 368,000 in 2021. And of course, the super specialists, very specific kind of spine surgeons, general surgeons, bariatric surgeons, plastic surgeons, just all kinds of very specialized specialists can make a whole lot more, half a mil, 600,000, not even unheard of to make more than that. But like I said, we're not going that deep. We're going to focus on this number right here, $260,000 a year for a primary care physician with about three years of training after medical school. So let's put that in, all right, MD, $260,000 a year. Now, you might ask, if you're a smart astute viewer of this video, you might ask, what about the cost of training? Because we know medical school is expensive, PA school is expensive. So for physician assistants first, because I am APA, so we are going to let me go first, if you don't mind. We're gonna do this. So based on the PA life, whatever resources they use, the average cost of a 27 month program, which most programs are 27 months, my program was actually 24 months, but that made didactic year 12 months instead of 15, and that actually made it a whole lot harder. So if possible, I'd actually recommend a 27 month, but me, I'm a glutton for punishment, kind of a sadist. And so I decided to, or not a sadist, it's more of a masochist, Jesus. More of a masochist, I'd like to put myself in situations where I will be abused and feel lots of pain. So I decided to go with a 24 month program, so it was a lot harder, but those three months of my life that I saved, I think they're worth it, honestly, even though I lost all my hair and put on some weight and probably did irreparable damage to my body due to the stress that that program caused me. But yeah, no, I digress anyway. So yeah, 27 month program is what I would recommend. So the average cost for a 27 month program for a physician assistant, a non-resident tuition is 88,000, resident tuition is 50,000. I think my program actually cost around 80 grand and it was a private college, so I'm not really sure, but let's just go with 80 grand just because I know that's what my folks paid. I got the GI bill, so I didn't pay anything, but people in my program, that's what they paid. So let's just go with 80,000, just my decision to do that. So cost of training for a PA, 80,000 dollars. Cost of training for an MD average is about 202,000 in state public school or 234,000 out of state private school. Since we're doing the higher number for PA, let's do the higher number for MD. So the cost of training is going to be 234, almost 235,000 dollars. So 235,000 dollars and let's label these X's just so we don't forget, annual salary and this is cost of training. All right, let's make this a little bit wider because I'm OCD and let's bold these because I'm OCD. Okay, solid. All right, so now we have some raw numbers to go with. All right, $150,000 on average for a PA, $260,000 on average for an MD both working in primary care. Cost of training, 80,000 here, 235,000 here. All right, so let's get into the nitty gritty. All right, so this is going to be, I'm assuming again that this person is coming out with no undergrad debt or maybe they're coming out with the same undergrad debt. I'm just gonna go with none just to make it easier. I know that's not realistic nowadays. People are graduating with 50, 100, sometimes $200,000 in undergrad debt. I think I graduated with like 50 but then I paid it all off while I was in the Navy, luckily. And then my GI bill, like I said, for my PA school, so I am a, let's call me lucky, let's say I'm lucky, but most people are not that lucky. Most people did not go into the military and have Uncle Sam, you know, Rich Old Uncle Sam cover their bill. So let's just go with most people like you watching this video what you'll probably have to deal with. So let's see here. How are we actually gonna do this? This isn't real time me thinking about this, so correct me if I'm wrong. But, and I'm gonna say also length of training. So here, let's just call it, you know, three years for PA because 27 months plus getting credentialed and whatnot before you start making money, let's just say three years. For MD, it's gonna be, what is it? We got the same undergrad, so it's essentially four years in med school, so that's four plus primary care residency, I believe it's three years, so it's actually gonna be seven. So this comparison's actually a little closer than I imagined it would be. MDs are trained for about four years longer than we are, just basically medical school. And then of course they have to get credentialed and whatnot, but let's just, let's give the MDs the benefit of the doubt. Let's say they can start working right after residency. You know, I'm not sure if that's accurate, but let's just go with it for simplicity's sake. So here's what we're gonna do. So here's how much the PA's gonna pay for training, here's how much the MD's gonna pay for training, so that's how much student debt they have. Of course there's cost of living, so actually we should probably throw that in as well, just because that it's actually substantial. So let's move this down. Let's do cost of living. Let's say about $20,000 a year, it's probably bare minimum in most US cities. You know, as far as lodging, car payment, if you have one gas tuition, or sorry, gas, insurance, food, the occasional beer, because school is difficult and you need a break. You know, who knows what you need to spend money on, but let's just say $20,000 a year at a bare minimum. So for the PA, because it's three years of training, let's call that 60, it's gonna get added to your student loans for the MD, because of seven years of training, let's call that 140. And yeah, that seems like crazy numbers, but I mean, cost of living is not trivial. You could probably get it down further, but I mean $20,000 a year, if you've ever tried to live on $20,000 a year, it's not much, it's really hard. So I'm gonna probably stand by that, I'm gonna go with $20,000 a year. $60,000 for a physician assistant over the course of three years, $140,000 for a MD over the course of seven years, all right? So here we go. Also, another thing I should probably do now that I thought of it, is MDs get money while they train for those last three years while they're in residency. So I'm gonna say pay during training. So for PAs, zero, once you got some sort of a scholarship, fellowship, whatever, which almost nobody does, I actually did. I did something called the AHEX Scholars Program, which gave me, I think, like $1,000, maybe $1,200, plus housing allowance for travel and whatnot, but another topic for another day, and that's not a whole lot of money. MDs, I think they get between 60 and 70 during their residency. I think also depending on what residency they do, so let's just call it 60 grand a year for three years for MDs, so that's gonna be 180 grand. And let's make all of these positives, let's make all of these negatives. So cost of training is obviously negative. Cost of training is obviously negative. Cost of living, of course, is the same. It's also negative. Cost of living is negative, and then pay is positive, and then this is just yours. Okay, so now we have all of our numbers to work with. So to the meat of the video, so PAs on this comparison are going to be working, let's say they get a job right away after those three years, they are going to be working for four years longer than an MD, making an average of 115 grand. MDs, on the other hand, during those last three years are working for about 60 grand. That is about the pay that you get during residency. So let's see. So basically comparing for those three years, PAs make nothing than for four years equals four times 115 thousand dollars, we're going to say PAs make $460,000 during that time. Of course, this is all pre-tax, let's just make this nice and simple and easy. MDs during training, so I got their pay during training, which of course I didn't do here, and then here, what do we got? Basically MDs just don't get that. So I'm going to say here, pay during four years, because that's how much more PAs are going to be working in the workforce than MDs. So basically we're comparing here. MDs are paying a whole lot more for school, they're spending more time in school, they have a whole lot more expenses during school because there was more time, and then they have this much for their training, $180,000 over about three years. PAs have a whole lot less to pay for training, they have a whole lot less to pay for cost of living during training because there's less time, and then of course during those four years that MDs are just not working at all, PAs make that up with $460,000. So basically at the end of the day, what happens after seven years? Let's see, after seven years. So equals 460,000 plus cost of training, which is a negative here, plus cost of living, and that's about it. Okay, so that's after seven years. All right, so PA, after paying off their entire schooling, entire cost of living, of course, I know there's interest, again, we're keeping this nice and simple, not keeping those five to 7% in our calculations, and of course we're going to not worry about taxes either, so this is probably gonna be realistically lower, but let's just stop for comparison's sake, just do this. So after seven years, the PA comes out on top with about $320,000. The MD, on the other hand, doing the same kind of calculation, we have $180,000 they made during training, plus their cost of living, plus their cost of training. So the MD, after they are all set and done, after those seven years, comes out at about minus $200,000. So this is where it gets interesting. So after seven years, the PA is plus 320 grand, the MD is minus almost 200 grand. So the PA is about a half a million dollars ahead after seven years, okay? Now naturally, a lot of this is probably gonna get spent on living. PA's get out of school, they don't wanna live on 20 grand a year anymore, they buy a car, they buy a house, they do whatever. These are things that are gonna happen, but I'm going straight by the numbers. This is how much more a PA has made over those seven years than the MD. MD after seven years, even though they made some money during their residency, of course cost of living, I'm taking out of that. During school, we have minus 200 grand. A PA has paid for training, paid for cost of living for three years. Actually, you know what, I think it would actually be fair probably to also subtract cost of living from the PA. How about we do that? Let's say the PA is smart, let's say the PA continues to live on 20 grand a year. So this is actually, let's make these the same since we're doing the same amount of time, right? So the PA is actually going to also live on 140 grand for those seven years. So now the PA comes out on top with about a quarter mil, 240,000 and the MD is minus about 200,000. So I think that's fair because we're now factoring in cost of living for the entire time for both. All right, so that is much more apples to apples comparison. So after seven years, this is the difference. Now here is where it gets interesting. Now the MD is going to make $260,000 a year. The PA is going to make $115,000 a year. All right, so we're going to say equals this plus in parentheses, this $115,000 a year times this and 14 we're going to play with and those are going to be years. All right, so right now this is going to be one. This is going to be one. And we're going to actually carry this over. All right, so here we go. So after one year, okay? After one year, the PA is ahead. Well, hold on a second. Yeah, now we're going to modify this a little bit too because we keep forgetting about cost of living. So we're going to say minus about 20 grand. Again, we're assuming that you are just living like a college student. You're really being smart. You're saving your money, you know, probably not accurate for a lot of folks. And again, this is pre-tax, but let's just do an assumption of about $20,000 a year for living expenses. Same thing with this guy right here. All right, this is going to be the same. And of course the doctor is going to have to keep living, keep eating, keep a roof over their head. So we're going to say this also minus about $20,000. All right, good. So after one year, the PA is ahead at about $335,000 and the MD has finally gotten out of the red. They are now at $45,000. After two years, the PA is at 450. The MD is at 305, which again, I don't think is accurate because we need to modify our formula again because it's $20,000 cost of living per year. So we're going to say multiplied by the number of years, right? That makes a lot of sense to me. So we're going to say again, $20,000 multiplied by this number of years that we're doing. Okay, so after two years, the PA is up to 430,000. The MD is coming in strong. We are now up to 285,000. After three years out of training, we are dead freaking even. Look at that. In three years after their training. So basically 10 years after they've both started, they both get out of undergrad. They're both 22 years old. However old you are when you finish undergrad, one is going PA route, one is going MD route. The PA is going like, ha ha, he'll never catch me. I'm always going to make more money than you compound interest, blah, blah, blah. And the MD is like, yeah, but I'm going to have a much higher salary plus I'll be your boss, so suck it. So now the PA would be totally correct up to about a decade. And then after that 10 years, the MD has caught up. Now they are dead even with how much they've made. All right, and then of course, you can see what happens after four years. The MD starts to get ahead after five years. The MD is way ahead by about 300,000 after six years and so on and so forth. The MD is just going to start exponentially leaving the PA in the dust. So that is the simple comparison. After about 10 years, the MD starts to get ahead. That being said, that being said, one thing we are totally, totally neglecting is compound interest and investments. So let's go back here. Let's go back here. One year out of training, all right. The PA has 335,000, the MD has 45,000. Let's say, let's say the PA put that extra 300K, approximately, you know, 90K, whatever, or sorry, 290K. So let's just say 300K. Let's say the PA put that extra 300 into a mutual fund for those five years. Because remember after about, what do we got, two, that's right. So for about two years, all right. So let's see. So for about two years, and I think I used this in the last video I did about money. So literally just gonna do, you know, two years. 65 to 67, let's say you got 300,000 in the bank, zero, to be very conservative, let's say 9%. Yeah, they've made about 60 grand. 60 grand, got you. Okay, so yeah, basically unless during that time the PA managed to be really smart with their investments, really kick-bought in the stock market, make really good picks, or invest in like property, you know, just very, very quickly over those few years. Basically after 10 years, there's almost no way that the PA is going to catch the MD as far as finances go, based on what I found here. All right, of course there's so much more nuance here. There's different specialties, there's different things that the PA and the MD could do. There's lifestyle creep, you know, let's say the PA keeps driving a Honda and living in a one bedroom apartment and just saving their money while the MD, as soon as they're out of med school and gets that first residency paycheck, they buy a Range Rover, they get like tens of thousands, if not hundreds of thousands dollars in debt, they buy a big house, you know, with a huge tax bill, like, or vice versa, you know, maybe the PA is stupid with money and the MD is super frugal, tons of variables. But basically, if everything is exactly the same and they are in the same specialty and they, you know, have the same cost of living and they have the total average costs of training and all of that, basically after about 10 years after they start their training, the MD catches the PA and then they start to, you know, get ahead faster than the PA will ever catch up. So that's the video, guys. Let me know what you think. I'll see you guys in the next video. And I think I'm definitely gonna keep doing these money talk videos as far as medical careers go, just because they are super interesting to me and super interesting, it sounds like to you guys, because that last video on the PA becoming a millionaire, how you could become a millionaire as a physician assistant did pretty well. So yeah, I think I'm gonna keep talking about this. Hope you guys have a great day, have a great weekend and I'll see you in the next video.