Physician’s Assistant vs Pre-Med

Just want to float an idea out for feedback.

Am I right in thinking that most students entering college intent on pre-med never apply to med school and that most who do apply are not accepted?

If so, that’s a pretty high attrition rate for a group that probably consists of pretty bright kids to begin with. Maybe 75%.

And is it the case that GPA + MCAT scores are more important than what undergrad college a medical school applicant attends?

So here’s my thought. Why not apply out of high school direct admit to a physician’s assistant program? This would guarantee that the student would work in the field they’re interested unless s/he fails to keep up their grades. There would be no big med school debt required, and instead they would get 6 years of financial aid if they qualify.There would be no anxiety about acceptance into med school, followed by the despair of “What do I do now?” If they aren’t accepted, as appears to be the case with most applicants. Starting salaries are very good for PAs, typically 6 figures or so I’m told.

But s/he really wants to be a doctor, not a PA! I get it. So, why not apply to med school in senior year even though on the PA track. I assume nothing would prevent that. I assume most of the bio, chem, and other science classes require for med school would be part of a PA curriculum or could be taken as electives. I may be wrong on my assumptions.


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Theres not as many direct entry PA programs.

I know of several new grad PA’s with no real experience who have been looking for a job for over a year now.

The number of jobs for PA’s and NP’s is area dependent. The market where I live is saturated. The good news for those new grad NPs is that they had to be nurses first and many fall back on picking up hours as a RN as they still look. For new grad PA’s who can’t find a job, their job search is very limited based on their undergrad degree or any work they did outside of school (I know many who took emt on their own for example).

NPs can practice independently too. PAs can’t.

I focused on new grads and a new grad np with no experience should likely not be opening an independent practice as a new grad np.

So, if it’s area dependent, why not just relocate to an area where there are jobs? People have been doing that in various fields forever. I don’t see why that’s a negative.

My point is that if a student is on the PA track, they have a fall back option. Compare that with the fact that most students who start out on the pre-med track never become doctors.

Many who leave the pre-med track end up deciding medicine isn’t for them - they like something else better.

Otherwise, for those who go the med school route the desire is often to “be” the doctor, not the person who works under the doctor and needs the doctor to sign off on things.

The PA field attracts many on its own from those who don’t want as much school, etc, but like med school - there aren’t that many slots available.

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Med school admissions committee’s don’t want to see “I’m almost a nurse except for taking the Boards, so you can see how committed I am to a career as a physician”. They want to see commitment to becoming a physician and practicing medicine.

It’d be a good strategy in my opinion, in that the likelihood of practicing medicine and helping people is much, much higher, especially for students who don’t especially know the profession well.

You are correct in that the classes are the same for premed or pre-PA.

Honestly, if I could convince my kid to go to nursing school and become a nurse practitioner, or a “doctor” of nursing, I would. Not because it’s anywhere near the training necessary - it’s most definitely not. But it’s shorter, much cheaper, much easier, many fewer hours, and the bar for admission is set so much lower than for medical school. Most of all, with an NP, one can simply hang out a shingle and call oneself whatever one wants - no pesky residency or specialty-specific board certification required. But my kid has the misfortune of wanting the education necessary to really understand what he would be doing. So it’s gonna be med school for him.

But yes, the PA option is a little bit less competitive, and a BA/BS-PA program is not a bad idea at all. If one gets really high grades in the BA/BS component, one can still decide on med school. But of course, one can go from any BA/BS program to PA or MD school.

But for those who are considering the PA option, they really should consider going the NP route.

Many people can’t just up and move due to family commitments.

Most PA schools have single-digit acceptance rates too. There are lots of options for those who want healthcare careers.

Creekland, I agree that some who leave the pre-med track do so because they decide that medicine isn’t for them. But what about the rest? What about those who stick with it but are rejected but every medical school they apply to. What do you say to them? They’re left with nothing.

And what about those who don’t proceed with med school because when it comes right down to it, they can’t afford it. Some can’t afford it because their circumstances have changed during their 4 years in college. What about them?

Then it comes down to the oft repeated advice on this board and anywhere else I’ve heard med school discussed. All pre-meds should have a Plan B. For those where Plan A doesn’t work, they fall back on Plan B. That’s what Plan B is for. Some of those will strengthen their application and re-apply later and some will stick with Plan B. It’s their choice.

Some will have their Plan B be a Caribbean medical school as they accept quite a few who can’t make it in elsewhere. That option will also need a Plan C because it’s far more difficult to match (for Residency) from the Caribbean - not quite as hard if one just wants Family Medicine though.

2plustrii, you say thay “many people can’t just up and move due to family commitments.”

If someone can’t take a job as a PA because s/he can’t “just up and move” to where the job is, how would that same person ever have become a doctor?

No one gets to pick their medical school. They apply and go where they’re accepted regardless of location. Same with post-med school training. No one gets to pick their residency. They apply and go to the one that accepts them regardless of location.

Yes, Creekland, everyone needs a Plan B. So what’s wrong with being proactive and having your Plan B already in place upon entry to college, i.e, acceptance into the PA track?

You can’t pick which med school that accepts you, but you certainly do pick which ones you apply to. Any you aren’t interested in attending you don’t submit an application. Some people do get accepted to more than one med school, and then, like colleges, they pick which acceptance they want.

Same deal for residency with the first part. A student doesn’t apply to anywhere they aren’t interested in being a resident at. After interviewing, one doesn’t rank any place they don’t want to end up at - and put the rank list in order. Most who get slots seem to have gotten in their Top 5 at my son’s school and only one he knows didn’t get a slot. She chose to continue in research.

Nothing is wrong with it if that’s what the student wants as their Plan B. It never interested my guy, nor did any other medical career. His Plan B was research. He came very close back when he was choosing to make his Plan B, Plan A, but finally opted against changing and is super happy where he’s at now - a week away from graduation and looking forward to his residency.

You don’t want to put your eggs in that basket out of high school. You might decide that business, computers, law, etc. is a better fit for you. Most do. It’s not because they can’t do medicine, it’s because they find passions somewhere else. Just go to college with an open mind. As you take classes, you’ll figure it out.

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It’s a little off topic, but I strongly advise the Plan B not decrease the chances for Plan A. That’s why I think Biomedical Engineering is such a poor choice. It’s too hard to get good grades.


Good points. I can only say that residency options are more limited by their nature because they are specialty specific and not general the way that med school is. It isn’t always possible to find a residency in your field where you happen to be living when you’re in your 20s. I think we’re talking about a very small number if people who don’t have the flexibility to move with the job market when they’re in their 20s.

They’re only super limited for a few more “exotic” (for lack of a better word) specialties. Many places need all sorts of doctors. Many students from my high school who wanted to stay around home (for residencies) were easily able to stay within an hour - two at most - and we’re semi-rural. (Not Wyoming rural, but East Coast rural.)

Couples matching is tougher to select location (region), but it sure didn’t seem that difficult for most at my guy’s school to get areas they wanted if they cared - from NYC to CA to within an hour of “hometown.” Pretty much everyone was super happy on Match Day with where they were going. (A few weren’t, but nowhere near the majority.)

Agree with most of the above advice–people who want to be doctors and do not get through pre-med as undergrads usually find something else they love better and they realize pre-med was never right for them in the first place and are content with the outcome. For those who do get in to med school, all have to be flexible and ready to move many different places in the US. Yes , you rank the residencies but they rank you too. If you are married to someone IN MEDICINE(or academic research at a medical school) (ie your partner is another med student or a resident), then you can couples match–rank the same list and talk to the depts in advance. If the other person is at a different institution, the department there can be contacted early on and often there are ways to greatly increase the chances of a match there. This is fairly common. Yes you take the risk it won’t work. But there are ways to transfer residencies too and in once in med school (the hard part is getting in!) there are many many folks who help you through it and set expectations. Almost everyone matches in their chosen field at the vast majority of med schools, and if you don’t get your top few residency locations you just deal with it.