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Session 75 This week’s poster is a practicing PA who has some questions about transitioning from being a PA to starting medical school. These are great questions commonly asked not only by PA’s, but also, by NPs and other nontrads who are in a healthcare-related field and would want to make that switch. [00:56] OldPreMeds Question of the Week: "Just stumbled across this forum. Happy to see there are other nontrads getting back on the horse too. I have a few logistical questions I hope you all could help me with. Background: I'm currently a practicing PA in Emergency Medicine in the ICU for around four years, 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 husband, undergrad major of chemistry with cumulative GPA of 4.0 and a PA grad school GPA also 4.0. All med school prereqs essentially met via PA school prereqs. Haven't taken the MCAT yet but started studying and plan to take in the next one to two years. Questions: Would it be more financially wise for me to work an extra three to four years, pay off debt, and save up for cost of living with my PA salary before applying to and starting medical school? Or would it be better to start sooner rather than later, let the debt build on holy amounts of interest throughout med school and residency and have med school debt added on top of that knowing that I'll be making more money sooner? Are there any legal issues or 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? Do I really need to obtain shadowing hours given my experience practicing medicine everyday? Should I be going back to school just so I can get science LORs (Letters of Recommendation) or would it be sufficient to obtain letters of recommendation from my physician colleagues and PA faculty members?" These are great questions that a lot of students switching from a career from another healthcare-related field like a Physician Assistant or a nurse have. Let's dig into each of the questions and discuss them. [03:14] Making a Financial Decision Is it financially wise to wait a couple years or do you start sooner rather than later? Yes, it would be more financially wise to pay off the debt before actually accruing more debt. This is a personal question that's hard to answer since you really need to sit down with a financial advisor and look at the lost income from giving up your PA work while attending medical school and the income you'll be making as a resident (which is most likely going to be a lot less than working as a PA) and finally, your work as an attending. What would it take to break even and pay off all of that debt and what that would look like. Be able to work out some different scenarios. Therefore, it seems more financially sound and wise to wait a couple of years. Whether or not it's right for you, it's a personal question that only you can answer. Do you enjoy your job well enough now to give it a couple of years? Are you dead set on going to medical school? If you wait a couple of years, are you going to question that decision? Or should you just jump in now with both feet while you're ready and your husband supports you? These are some things to think about. [04:40] Legal Issues and Conflicts of Interest Are there any legal issues or conflicts of interest against picking up shifts as a PA while in medical school or working during med school in general? Yes, people do this. I recommend that you talk with the medical school as you are accepted and you go through that process. Make sure you're accepted first and then go through the process telling them about you going to medical school and whether you could pick up some shifts. Your ability to pick up shifts is going to be few and far between since medical school is going to be rigorous so being able to work is going to be hard. But it is possible. Your credentials, certifications, and schooling as a PA are fine. If you need to change state, you're going to need to re-license yourself and all of that stuff that goes with moving to a new state. But you should be able to work as a PA. However, be careful with the clear delineations of what you're doing and what scope of practice you're practicing under. Back in Episode 170 of The Premed Years Podcast, I talked with Brad who turned from PA to medical student and he shared his journey, why he was doing it, as well as practicing as a PA during medical school. [06:10] Shadowing Hours Do you need to obtain shadowing hours? Yes. Working as a PA side-by-side with physicians is not "shadowing" a physician. What you see working as a physician's assistant while 99.9% of it is going to be the same, go shadow for 10 or 20 hours. You don't actually need a ton of hours. Just go shadow and see what life is like when you're not working and you're able to just observe and take it all in. You've gotten through your education, PA's work side by side with physicians and even as you're practicing, so you understand it. Still, go get some shadowing hours so you can put it down on your extracurriculars. [06:57] Letters of Recommendation Do you need to go to school just to get science LORs? No, you don't. Most medical schools are going to recognize the fact that you're a nontraditional student. If you ask them, they will say they won't need those science LORs so go ahead and use a supervisor and anybody else who will write a great letter of recommendation for you. [07:26] Final Thoughts These are great questions a lot of nontrads have not just for PA's but those who are also in the medical field. If you have any questions you want answered here, go to www.OldPreMeds.org and register for a free account. Links: PMY 170: PA Turned MD Talks About Why He Made the Shift