 Early on in medical school, I heard about the career of being a PA or physician assistant, physician associate, and I was like, what in the world is that? Once I found out, part of me kind of wished that I actually did it. Let's talk about the differences in this video, let's break it down. Hey friends, welcome back to channel. In case you're new here, my name is Lakshman, internal medicine physician, currently in about to be a cardiology fellow, but early on in medical school, I heard about the career of being a PA and the things that I heard about that will break down today's episode really made the field attractive, even at some points a little bit more attractive than being a physician. But today's episode we're going to break down everything from exactly what a PA is, the amount of training you have to do, the salaries, your job duties, and the future outlooks. But in case you're interested in a specific part of that we'll talk about in today's episode, I'll go ahead and put up all the chapters and timestamps right here as well as in the description, but let's get to it. Now first, let's talk about exactly what a PA is. Now a PA stands for physician assistant or as the name has been changed to be more appropriate for the role physician associate, it's relatively a new career with the first graduating class being in 1967. So hasn't really been around very much, but they get to do a lot of cool stuff. And as we'll talk about throughout the episode, you'll find that both of them are very competitive, both have a very good salary, both require different amounts of training, but still you have to work hard to get to it. But ultimately, both also have the independence as well as some flexibility in terms of what you do to make decisions to ultimately take care of patients. So we first start with the roles of what a PA can do, it's very similar to what a physician can do. Just like a doctor, a PA can see a patient one on one, they can help create differential diagnosis, they can help determine which test and labs to order, they can also prescribe medications, see patients for follow-up in clinics as well as assist and procedures in some cases actually perform themselves. When I was in residency and working in the ICU, often the best people to do a procedure like a central line or anything in the ICU happen to be one of our PAs. So for example, if you have a PA who's working in the ICU, you may have an ICU physician who's overseeing their decision making and may round with them during the day. If you have a PA who's working in the clinic, you may have a physician who's overseeing the notes and the decision makings. And occasionally we'll see that patient on the follow-up visit just to make sure that everything is okay. Now that last point is really the biggest difference in the biggest asterisk of why somebody would choose to become a doctor versus a PA. Really it just determines of how much independence do you want versus are you okay with somebody supervising and kind of titrating and adjusting your decision making based off of their preferences. For me, I knew that I wanted to ultimately be the decision maker and thus being an MD or a DO is a route that I ultimately pursued. But there's tons of people that I know including in my own family that are great PAs, love to take care of patients and are okay with having somebody kind of oversee their care. Some people even prefer it, but again that's the biggest difference. Now we're going to transition to the other biggest difference which is the time of training. So let's get into the admissions. So first let's talk about the prerequisites to get into PA versus MD or DO school. Now if we begin with simply grades we'll see that an average GPA for somebody who gets into medical school is anywhere between a 3.7 and 3.8 even higher for more competitive programs. On the flip side an average GPA for somebody who's getting into PA schools anywhere from a 3.6 to a 3.7. So votes still vary competitive academically to get into. Next we have to talk about the differences between the entrance exam. To become a doctor you require to take the MCAT which is like a ridiculous seven and a half hour exam that both students in MD or DO school will take. On the flip side to apply to PA school you're required to take the GRE or the graduate metric examination which is much shorter about three and a half to four hours long. There are a handful of PA schools that do require an examination very specific to becoming a PA but most students will apply using the GRE. Other prerequisites are very similar between both fields to become a doctor. Most schools will require the very similar list of biochem biology, one biology two, okay etc. to actually be able to apply to those institutions. Some schools have small adjustments and variations in their classes. Those same list of classes will be required to apply to PA schools. I did find that there's a big variation from institution to institution when you're applying to PA school where certain class may be required for this school and not so much here. So you do have to do a little bit of forward and proactive thinking in terms of your class planning but on the flip side to apply to medical school most institutions have the typical pre-med major which is not a major by the way but it's the same list of classes that most students will take to apply to medical school plus or minus one or two classes here and there. In addition to apply to both it's recommended that you have some leadership experience and community service involvement as well as maybe some previous work experience or interaction within the healthcare field to actually explain that this is why I want to be a PA versus a physician. Now I would say that the biggest difference besides the entrance exam that you have to take to get into one of these two institutions happens to be the requirement of patient exposure hour. Now to become a physician it's usually recommended that when you're applying you can show some evidence that hey I've done some stuff in clinical medicine I've shattered a doctor here and there I have reasons of why I want to become a doctor but there's no one asking luck you have to do an X amount of hours to apply to medical school. In fact I think I did about 100 hours of shadowing in one single semester of college and then the rest of it not so much it was just a program that I did I got my shadowing out the way I could talk about it a bunch on my application but no one had a minimum or maximum requirement. On the flip side you'll find that a lot of PA schools will actually have a minimum threshold of how much clinical hours you have to do and what that means can vary from institution to institution but you'll see that number go anywhere from 500 to a thousand to 2,000 hours that's why it's very common for somebody who's applying to PA school to take one or two years off have a prior career working as anything from a scribe, a nurse, a CRNA, physical therapist where maybe they're making a diversion from one career to another but again if I was to look at the application for somebody who applied to medical school versus somebody who's applying to PA school that PA applicant almost guaranteed has tons of more clinical experiences on their application compared to their MD or DO colleagues. And then lastly to close off this admission section let's talk about acceptance right now this is probably a big discrepancy and there's a lot of kind of variation in the data for medical school this number's kind of been around it's usually about five and a half percent to somebody to get into an MD school a little bit higher in terms of acceptance rate for a DO school but obviously very competitive one out of 20 applicants are actually getting into a medical school of their choice but now if we look at the acceptance rate at PA school you'll find that the variability is very large you'll find some articles will actually report studies from 30 to 40 percent acceptance rate which is enormously high for competitive field but on the flip side if you look at specific programs you'll see that acceptance rates are lows five to ten percent now the reason that there is such a big difference is one data varies from institution to institution there's not one good place of data compared to a medical school where there's tons of data for your acceptance rates how many people applied etc but number two is that there is a big variation in terms of the quality of a PA school you may have PA schools who are reporting all the people who applied versus who the people who got in compared to people who are actually eligible to actually get in meaning they met the admission criteria where they submitted a secondary application if it was required and then we look at the differences between who actually got in that makes the numbers much different so i would say if i had to put a number to it it was probably closer to that 10 to 20 percent depending on the institution but still very competitive to get into and there are significantly less spots to get into a PA school compared to most medical schools now next let's actually transition in time in training this is the biggest perk where PA hands down wins in terms of their career in terms of the length of training to be a PA you go to PA school for about 24 to 27 months about two and a half years on the flip side to become a doctor you go to four years of medical school plus anywhere from three to eight years of residency plus or minus extra years of fellowship for example i've done four years of medical school done you three years of residency and took a year to work as a full-time physician i'm going back for three more years of training and fellowship to be a cardiologist so definitely a big difference between the two and a half to be a PA versus the four plus years to actually become an independent physician but that's one of the most attractive and biggest advantages of going down the PA route if you want to make a six-figure salary in health care working with patients and being the primary decision maker for the most part PA is a great route because against two and a half years versus eight 11 years for some careers in medicine to become a doctor the other big difference that's nice to talk about now is the flexibility that you have in one role versus another now to become a doctor the further you go the more stuck you are in that field for example i'm a medicine doctor i'm not going to somehow transition to now taking care of kids or pregnant females or doing surgery that's not part of my role i'm too far into the process i would essentially have to go many years back repeat the process of training and residency to get there on the flip side if you're a PA and you choose i want to work in a dermatology clinic actually i'd like to do maybe some more basic procedures or i want to be in a family medicine clinic or i want to be a cardiology PA there is some transition that's required but you don't have to go through an extra residency or go back to PA school to do it you're exposed to all that during your two and a half months in schooling and then ideally you've had some experience that transitions nicely to your new role i see this a ton with the PAs that i work with you'll find that some have really cool histories maybe they worked in the emergency room they got tired of it now they're a critical care PA or on the flip side they're working the critical care and it just got too busy and now they're doing general internal medicine etc everyone does a different role but that flexibility is a very nice thing to have next let's talk about job roles and we've touched on this a little bit let's go ahead and elaborate again being a physician you pretty much have all the responsibilities what a doctor would do PA you pretty much can do most of those things under the supervision of an MD or DO but there are certain roles that it's very uncommon for a PA to do or you won't see them at all perform for example if you have a PA who's in surgery you won't actually see them doing the procedure they'll be to the surgeon you may have to see them actually taking care of the patient post op pre op but the surgeon will actually be involved in that sort of the procedure itself in certain states PAs have different roles in terms of what kind of medications they prescribe certain substances like opioids a certain state may say a physician actually actually sign off on the prescription ultimately certain states they may be allowed to but to paint a better picture in my current role as an internal medicine hospital is where I see PAs it's very common for a PA to be the first person that you may see on a consulting service so for example if I call the cardiology team to see somebody with chest pain the physician may be aware of the patient but they may send their one or two PAs that works under them in that service to go see the patient do the note basically come up with a management plan discuss it with the doc the doc will come back the cardiologist will see the patient and agree to most of the management most of those PAs have been doing cardiology for quite some time sometimes even more than the actual physician and so they're able to guide the decisions with maybe some adjustments now that's the inpatient side but on the flip side if you go to a clinic for example if you go to that same cardiology clinic you may actually see that PA who sees how you're doing and the physician may oversee the note or see you every other time while the PA sees you in the middle so finally let's talk about numbers how much money do you make in each of these fields now as a physician both an MD or DO again it varies greatly in terms of the field you do but the average salary ends up being about 300 $339,000 as of 2020 from medscape and again this is a broad range you can be in the field of pediatrics to primary care where you tend to make something a little bit lower in the 240 200,000 range or as high as something that's very hands-on very surgical procedural and you'll make anywhere from kind of half a million $570,000 if we break down the average salary and being a PA if we look at their results from the American Academy of Physician Assistance we'll see that the average salary reported is about 115,000 now I see a big variation in this number two I see some PA's will make right around that mark and some who are for example working in the ED or surgical route where you're just getting tons of patients that you're seeing because of the nature of the role that you do they're making close to like right underneath 200 to above 200,000 dollars now for both fields it goes without saying that where you work the job demand the flexibility your role in terms of how many patients you see as well as some of your experience and the bonuses and compensation structure of the group that you're joining is really going to greatly determine your salary so ultimately which is better now this completely depends on your personal preference like I mentioned if I had known about being a PA early on when I was a pre-med student there's a good chance that I'd be making this channel as a PA channel because shorter training make a good salary you can support your family no problem the United States on a six-figure income in most places of the state and you get to take care of patients make decisions and yeah you have somebody who kind of steers your direction making depending on their preferences but for me that may not have been the biggest issue back then if I was making that decision but two and a half years of training and then immediately start making six figures when I'm kind of in my early 20s versus now when I'm about to be 30 and finally have my first six-figure income I could say PA is very attractive but if you are somebody who just likes to be in charge likes to be that ultimate decision maker and as I've done this more and more in medical school that definitely happens to me then being a physician is a great route to go both have their perks both have their cons both make good salaries both ultimately get to take care of patients and there are physicians who are happy their physicians who are sad their PA's are happy PA's are sad so go on your personal preference if there's very specific questions you have about one field versus the other go ahead and add them in the comment section down below but ultimately if you want to go on one of these journeys to be a doc or be a PA and you want to do well then go ahead and check out down below a free download to our med school success handbook this is a document that I'm updating my team and I are updating on a weekly basis all those tips on how to study better how to be happy how to find that balance how to be that productive student that you ultimately need to be to be successful and fulfilled in your career again all the tips that I wish somebody gave to me on day one I'm just giving to you guys for free that'll be linked down below now if you enjoyed this and you want to see what my life looks like as a full-time hospitals this right here and if you want to see the difference between being an internal medicine doctor and a family medicine doctor check out this episode and I'll put in the description as well but as always my friends thanks so much for joining me on my journey hopefully I was a little help to you guys on yours best of luck I'll see you guys in the next one peace