Lifestyle choice: PA vs. DO/MD as a Climber!

Whatever you choose it's imperative that you are near climbing while in school, ideally an area where you can get out after work/evenings...my perspective currently in residency, happy and climb outside multiple times per week

L L wrote:

The problem is, I've asked this question to many, and I typically get a response including something about money or respect, which I care little about.

Did you ask them if they cared about money or respect when they were your age?

Dave Kos wrote:

Did you ask them if they cared about money or respect when they were your age?

A good point, certainly. And definitely something to think about. 

caesar.salad wrote:

Medicine takes over your life as an MD. If medicine is not your number 1, 2, and 3 priority, don't be an MD. There are plenty of other ways to enjoy the practice of medicine without being an MD/DO. I know MANY MDs who wish they weren't MDs. That includes junior residents through senior attending physicians. I don't know any RNs, PAs, or NPs who wish they were MDs.

My mother in-law is an RN who spent her entire career wishing she was an MD.

She would have been a good one too, but it just was not an available opportunity when she was younger.

Of course "the grass is always greener on the other side of the fence" ... so who knows?

PA - and not just because Phucking Awesome isn't a job title. 

ICU Respiratory Therapist here. I was on track for med school for a while but after talking with many MD's, I changed my mind, went to RT school, and got a job at one of the highest paying hospital in the nation for this profession. ($120k+/yr.) + 4 days off/week. I regularly climb outdoors with an RN, NP, PA and MD. The NP and the PA both love their jobs, but are required to rotate from night shift to day shift. They find it hard to reset their sleep schedule for climbing trips. The MD is an attending who doesn't often have time to climb. His entire summer is consumed with training residents. I've considered going to PA school in the near future as well. Not so much for the pay, but more for the independence, ability to write orders etc. If you want good pay, with lots of time off, be an RT or RN. More pay, with little bit more stress, PA. I am very glad I did not go through with medical school. 

PA or RN will likely give you the options of most flexible schedule..

im in DC (chiropractic) school right now and its great, gives the option of flexible practice but it can be a lot physically

My girlfriend is in her 4th year of Ortho residency (and also did 2 years of ENT).  She is still asking the question if medicine is the right decision for her.  It's not that she doesn't like it, it is just the time commitment.  She is a serious climber and struggles to find enough hours in a day to make it all work.  If you can function on 4 to 5hrs of sleep on a regular basis that will definitely help to make it all work.  In the few years we have been dating she has managed to make enough time to climb El Cap (nearly all free), climb in Patagonia, the Rockies, the Adamants, and all over the west coast.  She is obviously a very driven person with a lot more energy than most.  I'd say if you don't fit into that category finding time to climb is going to be real hard.  I consider myself a decently motivated person and there is no way in hell I could handle the schedule and energy output of her life.  I know a lot of people have asked her the same question about MD or PA and she would recommend PA everytime (or just go live in a van and go climbing...)

PA here,   I thought about the med school thing when I was younger, and blew  wit off to be a climbing and snowboarding bum.  Later found out more about PA and the profession.  Originally walked away from medicine to live my life, and not have it defined by being an MD.  Now I found I love medicine, but as a PA get to leave it at the door and was not saddled by an extra decade working as a resident and intern.  My Residency is my current life and work schedule, which is under contract for 12 shifts a month.... 

At the same time, I know a few docs who straight up Get after it.  Their energy levels are unmatched, although they admit to the enormity of the sacrifice during the 7+ years of school.  FWIW, I climbed a decent amount in PA school, and that was done in 2 years. 

feel free to PM me if you've got other questions, comments or concerns. 

Good luck

caesar.salad wrote:

Luke, if you want some honest answers, PM me. I got my MD and then decided to live in a van and climb full time. 

How can you afford to do this?

I'm guessing you got your degree, paid off your loans, put some money in stocks and live off the returns? But that's my guess. Care to share some insight?

L L wrote:

Thanks for the insight! The problem is, I've asked this question to many, and I typically get a response including something about money or respect, which I care little about. I've also meant multiple MD's who wish they had become engineers. However, none of those that I've asked are climbers, nor do any of them have any real hobbies or passions outside of their work and family.

Which leads me to posing my question here.

currently a MD in Emergency Med in my 2nd year of residency. I'm non traditional so started a tad bit later than most of the pre med folks out there. For some there is a lot that goes into that decision. I went to medicine because outlook on law sucked and frankly im not very good at being told what to do. What i do is also for the first time what i truly love doing for work. Climbing has taken a back seat over the past six years, however i still climb. I do 2-3 big climbing trips and am slowly getting back into monthly outdoor climbing - but schedule is limited with gf, hobbies, real life stuff etc. Average EM doc works 15 shifts a month and banks about $250K a year +/- location, bonuses, academic etc with a very broad range on actuall salaries. Other types of docs make less, make more etc... At the end of the day you realize you either dedicate yourself to climbing and spend your off time training for climbing, spend all your time thinking about climbing etc.... or you come to terms with the fact that you're not going to be the next sharma/caldwell etc and you enjoy a ton of other things and your not going to pigeon hole yourself into one thing or another. This will make you a massively more interesting person and can likely at the end of the day provide a more fullfilling life. Your mileage may vary... 

also re loans. I'm deep in the red as i dont have super wealthy parents. I make income based repayments which are more than manageable. I will pay off my loans in 2-3 years most likely post residency. I still am able to save and invest some. My gf and i live comfortably, and are not wanting even in residency. We don't drive fancy cars and live semi-frugally. cesarsalad said...frugality goes a long way and being happy with what you have while always a challenge in the context of others around you is the key. 

L L wrote:

Thanks for the insight! The problem is, I've asked this question to many, and I typically get a response including something about money or respect, which I care little about. I've also meant multiple MD's who wish they had become engineers. However, none of those that I've asked are climbers, nor do any of them have any real hobbies or passions outside of their work and family.

Which leads me to posing my question here.

I have a question , a hypothetical one.

Lets say, you have an accident that prohibits you from actually climbing, or makes climbing less appealing to you. 

Which career path would you rather be on if you could not climb or it's priority in your life shifted?

I encountered a similar dilemma last year after initially pursuing a BSN upon leaving the military after 8 years. I was worried because I was starting school at the age of 28 and did not want to waste "the good years." An EM physician from my state messaged me on MP after seeing my post, and actually got me a job as an ED scribe in a level I trauma center here in Phoenix. Since climbing with him and talking with other doctors at my work, I decided to make the switch to medicine and haven't looked back.

From my experience working there though, presumably like yours, the PA's and NP's I've worked with seem happy with their decision, however, they are only able to see 3's and lesser acuity patients. I haven't heard one EM doctor tell me they regret their decision and they make ~400k/year for 30 hrs/week. No on-call. No pagers. The RN's appear to be miserable and I can't say that I blame them. 

Personally, I am pursuing emergency medicine because I genuinely love the field (particularly the trauma aspect) and can't see myself doing anything else. As such, I want the autonomy of an MD with higher acuity patients. That was ultimately the impetus for me to make the switch. I think you need to ask yourself why you are pursuing the field of medicine, and you will likely answer your own question. If you are content seeing and treating lower acuity patients in most healthcare settings (obviously some exceptions to this), then PA is likely a good route for you. I will graduate medical school when I'm 35, and receive my first real paycheck at 39 if all goes according to plan. In the long run though, I will never have the question of "what if" looming over me. Getting a doctorates degree also gives you flexibility later on in life if you want to start teaching. Just think about what you want in life, and then decide. But just make sure you think of the long term and don't let yourself get scared into settling for something less.

caesar.salad wrote:

Wow and I felt guilty for getting Medicaid. 

Acmesalute76 wrote:

Wow and I felt guilty for getting Medicaid. 

I know right?

caesar.salad wrote:

Dirtbag for 25 years and you can celebrate your victory over The Man!

Acmesalute76 wrote:

Wow and I felt guilty for getting Medicaid. 

Nobody has actually completed the 25 year term yet. The first batch of 10 year public service forgiveness victims....i mean...borrowers have just started to hit the 10 year term and apply for forgiveness. Many, who met the requirements set 10 years ago, are being denighed loan forgiveness.

Should your loan be forgiven, the principal counts as income in the year it is forgiven. Forgive 100k in loans, you owe 17k in taxes...

Yeah, I think a lot of us are eager to see the fate of PSLF. 

Daniel Hamilton wrote:

Nobody has actually completed the 25 year term yet. The first batch of 10 year public service forgiveness victims....i mean...borrowers have just started to hit the 10 year term and apply for forgiveness. Many, who met the requirements set 10 years ago, are being denighed loan forgiveness.

Should your loan be forgiven, the principal counts as income in the year it is forgiven. Forgive 100k in loans, you owe 17k in taxes...

No, this isn't public service loan forgiveness. That's a different program and they are not mutually exclusive. But that is true that you do have to pay taxes on the part of the principle that is forgiven. I'm fine with that. I was the one who chose to attend medical school and take out loans. I don't find that unreasonable.