PA Student here! And in all honesty, this sums it up exceptionally well. I went into PA school because I'm personally fine with working as part of a physician-led healthcare team because I'll still be leaving a positive impact on the lives of patients. I don't mind taking a step back and dealing with the "bread and butter" of medical care. In my pre-PA experience, the PAs I've worked with always enjoyed working very closely with their supervising physicians. Even now (in my program at least), we're all very well aware that we aren't at the same level of depth as our physician colleagues. I have zero intention of seeking independent practice nor do I think that my current training will ever equal that of a physician's. Hoping to throw this out there to show we're not all engaging in scope creep.
Deciding between wanting to go to PA or NP school. Is PA school like crazyy difficult? Ik NP don’t follow the medical model so NP school might seem less stressful,
@@HannahTran1 Well, to be honest, neither NP or PA school are easy. It may statistically be less competitive to get into NP school than PA school, but both will still challenge you. The nursing model doesn't necessarily make learning the material easier. The NPs I've met who worked as Nurses prior to their NP training can definitely attest to it being very stressful (although many NP programs do allow you to work part-time as an RN while attending). I wouldn't recommend going to NP school unless you've had at least 4-5 years of full-time nursing experience, that was the initial purpose of the NP profession I believe, to build on a nurse's prior experience and advance their practice. As a PA student, I can say that although it isn't as in-depth as med school, it is still A LOT of memorization and studying. It's basically a full-time commitment and you'll definitely be sacrificing a lot from your own personal life and won't have that much free time. PA School basically tries to cram as much of the basic foundations of medical practice as it can in 2-3 years. I can't speak for NP school, but PA school covers all the specialties of medicine whereas I believe an NP program will emphasize the specific specialty that you chose (i.e. Family Medicine, Pediatrics, Psych, Women's Health). For a TL;DR: Yes, PA school is very difficult and takes up a lot of your time. Lol. But, I wouldn't necessarily say NP school is "less stressful" either. -Hope this helps :)
Couldn’t agree more! You don’t see much positivity written under this comment… but you see lots of negativity written under the comments of other PA-S’s and other mid level providers/students who felt disrespected! The idea of scope creep is definitely real and as a PA-S myself I feel that more NPs are trying to work independently in a specific field like an MD (and have successfully gotten that independence) but ALMOST ALL PAs know their role in healthcare and especially in surgery as a first assist! This video lumped all mid level providers together in a way that was misguided and not as informed regarding legislation and without ideas of what each mid level professional organization has been lobbying for (PAs = optimal team practice, more direct pay from Medicare, team of review board PAs instead of MDs while NPs are actively fighting for their aforementioned independence). I have watched this creator’s videos for a long time and love their work on study habits and different specialities but their lumping of mid level providers and non clarification of their intentions was a little off, as well as his discussion on “doctors being too busy to lobby for the AMA” (insinuating that PAs off work spend their time lobbying and not with their families/side hustles) was a little demeaning. I will continue to watch his content as he’s a great creator but needs to be less biased while curating videos like this!
Being a doctor is because you love to serve and make fast decisions to save lives. I gave up everything to be doctor I’m yet to regret it regardless of the difficult path. It’s a passion that I will repeat over and over again without thinking twice.
I am loving the dip into the non MD fields. As an x-ray/MRI technologist it makes me excited that one day you may find the time to make a video on the technologist/technician/assistant fields.
@@MayISpeak Hope he goes into it! The school is fast paced and difficult to consume at first but it is absolutely worth it. Every hospital needs more technologist.
I am a PA, and the comments on here by other mid levels baffle me. Lol. If you want to be autonomous without jeopardizing patient safety, got to medical school and complete a residency. I am in a PA Emed residency (18 months), and boy am I glad I chose expand my knowledge and continue learning in a supervised environment. Seeing MD/DO interns shitting their pants when a DKA patient with underlying urosepsis presents to the ED and requires pressors reminds me how Important it is to have thousands of hours of supervised training. Think patient safety, not useless titles. Thank you MSI, great video!
how long does it take to become a PA right after high school? i’m a senior and i want to be a PA but considering doing working RN then NP after experience instead just to be able to provide for my parents while I can
@BriannaOfficial I have to second that. As a resident I was so happy that I had an attending with years of experience to bounce my opinions off of until I felt confident enough to do it on my own. So it mind fucks me to think that I felt that way, with significantly more training than a PA, but here come these 28 y/o fresh out of PA school thinking they are some hot shit, lol.
@@oeowowowowiei6412 Im in medical school (MD/DO), but I know a bit about the PA track! First, you must complete a 4 Year bachelor’s at a university and make sure you have met all pre-reqs for entering a PA program regardless of your major. There is also a required amount of clinical hours you must achieve before you apply, which differentiates PA programs from MD/DO programs (many of us do have clinical hours upon entering medical school, it’s just not a requirement like it Is for PA school). It’s a pretty substantial amount, so I know many people will take a year or two working as a medical assistant or something before applying to PA programs. Then your PA program Is 3 years long. Residencies/fellowships are not required nor expected for PAs like they are for MD/DO so you are able to practice/find a job right after you graduate PA school. So, realistically, you’re looking at about 7-9 years post-high school for PA vs the minimum 11 for medical school (MD/DO).
I left the medical track for nursing when I realized that I wanted to be a mom more than anything. No disrespect to my MDs and DOs out there. Y’all are some of the hardest working people I know and I value your clinical expertise. It just wasn’t for me.
That’s kind of my boat. I’m 24 and having a family and free time to travel when I’m young are so important to me. I feel nursing will give me that life while still helping people. Though being a doctor does have appeal bc I like being in charge! Lol
@@khaleemaalkainaat8178 if that’s the best decision for you, and you truly love what you do, that’s awesome! Just here to say you can have all that and apply to medical school! I didn’t even apply until I was almost 25 and made it a point to travel and have fun before then! I literally had to fly in from South Korea back to the US for my interviews lol signed up to do one of my electives for a month in DR for my 4th year, and have been to other Caribbean islands coming up 3x in March since being in medical school. I also know people in their 30s in my class married and with kids. Nursing Is an amazing profession, and it absolutely allows more flexibility; but you can find ways while pursuing your MD too.
@@sydneyoneal7463 may I ask what profession you had before applying to med school? I'd love to travel before med school but I'm not sure what I would use to sustain the costs
Finding this thread a bit late but just wanted to point out that you don't have to eschew med school if you want to be a mom. I'm a 4th year student at a great MD school and I am married with 2 kids. It's definitely not a cakewalk and you have to really want both things in order for it to be worth it in my opinion.
@@LaurenMichelleMD you have probably one of the oldest created accounts on TH-cam. It’s rare and also great to see you’re still active just very recently!
I'm a college student, and like many other people, I have to learn everything on my own because I never learned about this. Sometimes, I just need a helping hand and I really appreciate you explaining everything so nicely. It was very clear and to the point, and you have a great narrating voice (not the monotone voice). Thank you for this explanation.
Hello! this is a big ask but i was wondering if i could contact you privately about your job and what you enjoy and dislike about it as i am currently in education aspiring to be a np Thank you!
Being a physician is a noble passion and a calling. Requires a lot of hardwork, dedication and years, NO SHORTCUTS. I’m happy, fulfilled, occasionally stressed but will study medicine over again if I have to. ❤️
I've worked for a psychiatric hospital for 28 years and never really understood the difference between a PA and NP because they appear to do the same job. This video was helpful.
Until MD/DO schools get cheaper, or primary care physicians start getting compensated appropriately, I don’t see the primary care physician shortage decreasing. The people suffering because of that are the patients, because they deserve well-trained, talented physicians but fewer doctors can afford to go into primary care after med school because our loan payments are so extreme.
NPs do just fine for primary care. I am not sure they’re suffering because a lack of physicians, but rather a lack of access to healthcare in general. Trying to prevent NPs from helping is a mistake
@@memali2939 depends on the specialty. Both my primary and psych providers are NPs, and I’m fine seeing a NP/PA in those specialties. Both providers are knowledgeable and spend a lot of time with patients. On the other hand, I prefer to see a physician for more complicated specialties like ENT and GI
@@ThatGoodBarbequ NPs do not do fine for primary care. Their training is greatly inferior. They completely miss rare conditions. They often every child that wheezes has asthma leading to frequent misdiagnosis and unneccesary medications. many can't even treat a common cold properly prescribing steroids, inhalers, and antibiotics when most of the time none of those are required.
As a PA none of this matters. I function independently in a rural community. No one wants to work rural healthcare. We will happily take an MD, DO, NP, CRNA, or PA any day. People need care. There arent enough physicians especially in primary care. We didnt make it that way, we are just trying our best everyday. We have to practice at our highest scope of practice out of necessity. Just like community health aides in Alaska. So we are waiting for you no matter what path you decide.
I'm in my BSN (graduating next year) with intentions to get my MD/DO. Many of my nursing professors are NPs and are very transparent about how different it is from being a physician; primarily, they felt way less prepared right out of NP school and had to work extra hard to be knowledgeable. That increased their anxiety, exhaustion, and depression, especially working alongside residents
@@deansamuels2247 when you’re making 300k+ that debt isn’t the end of the world. It’s an issue if you go to the most expensive med school out there then end up going into a field that pays below 200. I finished with 300k debt and first job paid 410k. I’m not stressing about payments 😂
Some NP specialties such as Neonatal or psych prepared you very well before you graduate. Higher income comes with higher taxes don't forget that. Anyway 300k is not bad for medical school, but alot of ppl I know owe more than that for medical school and they may not match into high paying specialities. You can look into scholarships though.
Truthfully I think being an MD makes less sense every year unless you want to do surgery or just want the status of being called a doctor . When you look at the 8-15 year commitment, the cost of school , the lack of flexibility once you specialize, and lack of sufficient pay during residency it becomes abundantly clear which path most people are going to choose. Med school has become more about draining students wallets than training well educated physicians. PAs and NPs are well compensated right out of school and don’t have to put their family lives and lives in general on hold until their early to mid 30s. If we want to fill the current void of primary care doctors then something about the MD pipeline is going to have to change pretty soon.
If you wanna know wtf you're doing become an MD. NP and PA is for people who wannabe docs but are not willing to put in time commitment to be competent in medicine and looking for short cuts
Nah, I’d rather just not be 30 something to start paying off my debt properly. I’d also rather start a family earlier, buy a house earlier, and live life :)
@@lolalolalola3801 that’s a very arrogant way of thinking, they’re obviously different roles and I don’t think there are very many mid levels who would disagree . The idea that you cannot be “competent” and be a mid level is also silly.
As an NP, I think there are two major problems with the current way of training. The first being that some schools do not require hours of work as an RN prior to entry.. how is that possible? The second being that the masters and doctoral programs are not a clinical focus, but a science theoretical focus which does not help for the actual job.
Wow. Very rarely do I hear this stance from NPs, but this is exactly the problem! Thank you. The fact that so many NP schools are now just looking for anyone that can pay tuition is watering down the field, and then those same people, without the RN experience, without the "smarts", are lobbying to practice independently. It's a money grab. Period. And it's dangerous! A well-trained NP is indispensable to the medical profession, but an ill-trained NP is a danger to all!
@@dr.deniece6399 I agree. I think NP's have so much continued potential if only all programs had an admission standard & were better optimized in terms of their masters/doctoral time to be more clinically focused. I'm in Canada which has a higher admission standard than US schools - but the overall problem is North America wide.
Been watching since the “How to study better video four years ago” when I was still in high school. I’ve learned so much for the profession I strive for here (MD/DO). Keep up the good work!
It’s important to learn how to study. I never knew how to study nor did I have to study growing up in school. Learning medical knowledge it’s important to understand instead of memorize for critical thinking. I struggled whenever I had to rely on critical thinking because I wasn’t understanding and learning. I was studying to pass exams instead to understand how to apply them. It took me my whole tenure to understand finally how to study. You got a head start so you’ll be good!
NP student here. This video is basically sums everything up. Chose NP because I know I do not want to sacrifice my 20's so I am basically prioritizing lifestyle.
@@jiya5423 your msn is your masters of science in nursing. you can get this after your 4 years of undergrad. some people get this degree just to further their nursing education/make more money at work, but going to NP school results in getting your MSN because you’re getting your masters. A DNP is doctor in nursing practice, some nursing specialties require this but it’s mainly a way to further education and be rightfully named “Dr. _____” even though you’re a nurse.
Thank you so much for making these and breaking down the various career paths. As a 34M who’s hates his career in tech, the idea of switching to healthcare is absolutely overwhelming, but it’s something I want to do!
Ooh, I’d also love to know if you decided to pursue medicine. I’ve been in the healthcare world for a long time and was trying to make the switch to tech, but find the doors closing often. Thinking it may be a sign pointing me to stay in healthcare.
NP here. I had 15 years of RN experience before I became a NP, over 25,000 hours of emergency room and critical care experience. Plus, board certified in critical care for many years. I'm glad to have worked collaboratively with all team members but I feel like many don't realize how much of my critical care RN background has helped me as a NP. Just a RN/NP perspective in the grand scheme of things. What's interesting too is some of the privileges I have to fill out for a NP are for RN duties, like placing a foley, a dobhoff, or even an IV. Although I place Central lines, HD catheters, Swans, intubate and place chest tubes now as a NP a lot of my previous RN duties overlap with the APP.
The MD route at one point in time probably made a lot of sense but unless you want to do surgery or just be at the top of the chain it doesn't anymore. By the time you factor in the debt, malpractice insurance, liability, time, and schedule it no longer makes sense. Sure they earn more but they also don't fully make it into the workforce under their own practice until 5-10yrs later than PA/NP and those routes don't have even close to the same expenses. The PA/NP can still write prescriptions, make care plans, order labs. They both make pretty good money. I don't see many situations where in modern times it makes sense to get the MD and that's why I think you'll continue to see a shortage.
I agree. I'm finishing up my BSN while working in the hospital currently along with my other job and I'm looking to become an NP. I understand the contentions and struggles between MD/DO and NP. I think mid levels are good, but I would never work as an NP on my own. Perhaps I would have the correct amount of training years into my profession, but there is something nice about being able to bounce ideas off of someone else who's qualified and to talk to them as an equal about patient care. Prevents medical inaccuracies occuring. Sadly, we're in a position where no one wants to work throughout their entire 20s to become a primary physician. At that point, a lot of them would then want to go into specialty and make a lot more money. I will say that there is a bubble with NPs who graduate and have no idea what they're doing because they were just trying to prescribe and diagnose without doing the hard work of understanding the pathophysiology. I see it in undergraduate and the workplace all of the time. So, I understand MD/DP frustrations there and it's not really just a lack of training issue. It's that some people will always try to find shortcuts and aren't genuine about being excellent providers, but making money.
At the end, don't forget to mention that scope creep is partially due to task shifting from higher level professionals to lower in order to meet the public health burden. We don't have enough doctors, and so NPs and PAs take on more responsibilities in order to fill in the gaps. It is shaky ground to have expanding scopes of practice without proper comparative educational standards, but there are significant benefits compared to providing no care at all to populations who cannot reach a MD/DO.
First, I want to say I find this video incredibly helpful. I’m a current nursing student who’s struggling with deciding what I want to get into after I get my BSN (between doing NP vs PA). That being said, I felt that the sudden about-face by the last minute of this video from objective information to “yeah, all these fields are fine, but seriously MDs you should be scared, NPs are coming after your money, patient care is failing, emotions are winning over facts, must remove toxic from the community” was… entertaining to say the least. XD I mean, I get the slight bias, this is a Med School YT channel after all. Not even saying some of the points aren’t well-reasoned. Just saying the acute shift in tone was not lost on me, and I found it slightly jarring/very interesting.
Thank god I’m not the only one. I was on board with most of his points until it turned weird at the end. Like, it got strangely politically loaded about how NP/PAs who seek greater scope of practice are subject to the “current climate of putting emotions over facts.” That is just conjecture with no data to support it and I expected better from this channel. Also, the physician lobbys are very powerful. Much more than NP/PAs are. Idk where he got that information
As someone who applied and was accepted to PA school this year and while I agree with the majority of this video, I would like to add that the average accepted PA student has a 3.6 GPA (and this will include all grades even if you used grade forgiveness). You are not considered commpetitve if you don't have 2000 patient contact hours. On top of that, PA schools also look out for healthcare hours (different from patient conntact), shadowing, volunteering, research, and leadership hours just the same as med school. It took me many years before I felt competitive enough to apply.
Does it help that I’m in a program to becoming a Cardiovascular Technician and currently doing direct patient care? I’ve never gone to real university but I wanna join the PA program and first get my bachelor’s degree before applying
I would just like to add that many PA schools also look for shadowing & volunteer hours on top of patient care experience. As well as some PA schools are requiring the PACAT now in addition to the gre.
Was going to say the same thing. I'd also say that the average required patient care hours is more around 2000, along with required healthcare hours, volunteer hours, shadowing hours, research (less so than med school), and leadership hours. It took me 2.5 years to feel competitive enough to apply. This is coming from someone who applied and was accepted this cycle.
Excellent. Later in the vid, you mentioned something like, basically 'fact-focus' versus 'feelings-focused practice. And bringing those circles of study less apart each other. A practice in humanity must be both. No flower has only one petal. Human health is the same way.
As a patient, my experience is that NPs take patient history and physical exam more seriously than MDs. I usually feel that my care from a NP is better than from an MD. I have been more thoroughly treated and more gently treated by the NP. Obviously, I am a great fan of NPs.
I was premed, switched to the nursing/NP route after working in a hospital and realizing how much more interactions nurses have with their patients, than their physicians.
@@theminimalist1549 it’s true. This has led me to think; go nursing route if you want more contact with patients or go medical route if you want more contact with other healthcare professionals.
@@theminimalist1549 "lol sure you did" meaning what exactly? Doubting that the they chose nursing over medicine? I'm curious as well, but you didn't need ti make such a condescending quip about it.
@@99krispin Yep, 100%. I’m currently decided between med and PA school since med school is so expensive but the interest just increases it. I don’t know how fast I’d be able to pay off the loans+interest if I were to go with primary care 😬
An interesting thing with federal student loans in the US is that PA programs are not yet recognized as a "medical" program, so they don't benefit from a higher cap on federal direct unsubsidized loans. For example, a student in a DO program (or even a Doctor of Naturopathy program) will be able to take out about 40k in unsubsidized loans before they hit the cap and have to begin taking out Grad PLUS loans (which have a higher interest rate). Whereas a PA student can only take out about 20K before having to start taking out Grad PLUS loans, despite the comparable annual tuition costs. Even masters students studying public health or health administration have an increased cap.
@@99krispin That’s so entitled. The government doesn’t owe you interest-free loans. And an interest-free loan isn’t equal for all parties; the government would be losing 2% per year via inflation. $100,000 today is worth about $150,000 in 20 years.
Love this video! One of the most informative and thorough videos out there regarding this topic! And kudos for shouting out the PPP! It's about time we start fighting for physicians rights. :)
Could you do a "So You Want to Be" a Genetic Counselor video? I love watching your videos because they have greatly helped me in my journey in science and medicine and in deciding my career path.
What really needs to be addressed is how poorly conducted some of these collaborative agreements are. There are some NPs who are practicing while the physician who is ‘supervising’ them is actually miles away mindlessly signing off charts so they can collect a extra paycheck. They aren’t actually supervising them at all, just accepting liability and collecting money associated with it. This is why midlevels have successful state hearings regarding FPA. The argument ‘midlevels need more supervision’ never holds up once it's shown how ridiculous some of these collaborative agreements are. Physicians are then painted as greedy money grubbers (which to be fair, in this situation might be true) and FPA is awarded to the midlevels. If FPA is to be stopped, we on the medical side need to clean up poorly managed collaborative supervision. Personally I’m not worried about FPA because patients are starting to recognize the difference in training and many express angst they can’t find a physician in their area; only midlevels. I’m applying FM this year and am excited for the future of it.
I understand your point of view, but this like you said this situation is prominent in some practices. That’s is why there are organizations to check situations like these and if you’re not doing your part in reporting it, then you may be part of the problem as well. It’s unfortunate that that is occurring but you’re acting like there is no remedy for it.
I'm sure a lot of people are wondering what path they should take. as a doctor myself I always give people this advice: *once the opportunity to apply to med school has arrived or is arriving soon, if you are not 100% certain you want to go to med school, don't do it*. Med school is not for everyone and there are many patient-centered professions that don't require what med school and residency does. I'm sure there are many who would say "I wasn't sure about med school but now Im an MD and so happy with my decision." While this is true, it is an extremely risky life commitment to make if things don't pan out and you have 400k in debt and no medical license, or you do but hate your job.
this advice is why I didn't do it. I graduated with a 4.1 GPA, all the shadowing and letters lined up to go. But I kept having doubts about it and couldn't do it. I'm in an accelerated RN program now, occasionally I regret not going to med. but when I see my college friend who is doing MD in the same center I am reminded he will still be in residency when we are 34
@@OllertonMD everything works out in the end. I wanted to do anesthesiology if I did med so worse case I go CRNA later anyway. what specialty are you in if you don't mind me asking?
@@jakehermo3075 psychiatry, in my final year of residency :) ! its nice going from being treated like garbage as a med student to being treated with decency now haha
@Simple Psychiatry MD I've always wanted to be an MD. In fact I started out pre-med, but changed later on due to certain situations in life preventing me from going to school entirely. I'm now in respiratory therapy, with the goal of eventually going for PA. I'm 32, but with other factors besides time at play, medical school and residency would probably overall have a negative impact on me. It's unfortunate because MD is what I've wanted as far back as I can remember, but I can say I've found that I love work life balance I have as a respiratory therapist, and that can very much translate over into the work life balance a PA can have. Definitely a positive for sure, but deep down I'm going to always want that MD.
I am a physician. Has bern one for 26 years after Med School. I don't regreted it but aftercso msny regulations and disrespect toward physicians, I'm advising my daughter not go to Med School and to do the NP route. I see my NPs that work in my setting more happier and less stressful that us with EHRs, licenses, MOC exams, CMEs, and patients unreasonable expectations.
In Ontario NP's can prescribed (limited) medication. Even my teacher in nursing school got an extended class license (she was a RN) to work as an NP and work North of Dawson City, Yukon where there were no MD's. I believe even now a RN/ RPN can give OTC medication (depending on your institute policy) without a prescription as long as they possess the knowledge, skill, and judgment to do so.
That part about varying from person to person is what makes years of experience not useful... If something like that were to be implemented, there would need to be exams along the way to ensure base level of competency.
I’d like to see more on people looking for a reliable Bridge Program from PA to MD/DO. While not everyone will be interested in doing so, I think outlining a better more clear avenue could aid PAs who are in fact ready to take that next step in medical training and knowledge. Even more so they will already have on the job knowledge and experience that would be very valuable to carry upwards.
@@MJL144 I am a PA. If a person wants to obtain an MD, that person goes to medical school. There is no short cut just because a person is already a PA.
@Elizabeth Brandon but a bridge program would be nice, right? Doesn't mean you have any less training overall, or have it arguably any easier, it just builds and expands on PA. I don't think it would be entirely impossible to bridge that gap. Say a 2-3 year program for current PA with X amount of experience, then residency on top of that. Obviously, this is all hypothetical, plus coming from someone who has yet to attend PA school so I don't know what it is like. I myself am in respiratory therapy, with the goal of eventually going to PA school. While MD would be nice I prefer the work life balance that I have now, but want to do more. Hence why I'm going PA. Even if a bridge program from PA to MD did exist, I probably wouldn't make use of it as I'm fine working my three to four 12 hour shifts a week.
As a licensed psychotherapist who just got licensed as an RN yesterday, I went to nursing school specifically to be a psych NP. I think psych is certainly different (comparatively) than most of medsurge focus of the video, but for anyone to argue that physicians are not more qualified and vastly more knowledgeable (and should be compensated as such, esp given med school expense), has lost the plot. I already have 12.5 yrs of school (w/ 5 more to go), will have two master's and a doctorate, and still understand this. Will not being called "doctor" after all this suck? Am I a complete idiot for not going to med school given my ridiculous amount of time already in college? Both of these answers are a "yes" if I'm honest. Had I gotten my doc in psych, I would have been called a doctor because it is representative of having a terminal degree and being at the top of my profession. I started in a program (7 more years for clinical psych) but changed my mind because there was very little else that I could do professionally and the time/money did not seem to bring a significant advantage. Back to vernacular; I've worked with many of these "doctors" and they always present themselves as "Dr. such and such, clinical psychologist." The one DNP that I've ever came across did the same. The problem is, most people have no clue what a DNP is, so...that needs explanation in my opinion. Dunno. I understand both arguments. And, I'm a "facts over feelings" kinda guy. In academia, we have created a mess with chasing titles because titles = prestige, where prestige = competence and wealth. This is another rant altogether.
as a DO I would NEVER become anything other than a doctor. time and money spent were well worth it, dont let anyone (esp someone who did not got to medical school try and convince you otherwise)
I am 43 and decided that being an cert. Opthalmic Medical Technician is just not my vibe. So, here I am plodding along to get my BSN ,minor in psych and forensics. Then onto my NP. I'll probably be 50 by the time I'm done 😂 but done I will be ❤
Not sure I totally agree. It is the responsibility of any provider in primary care to admit what is beyond the scope of what they can treat. Just because an NP may be less experienced doesn’t mean they shouldn’t be able to practice independently. They can practice independently and still refer out patients that are beyond their capabilities to either a primary care physician or a specialist. Just as a primary care physician is expected to refer out certain conditions to specialists.
Thank you for this! I am leaning more towards the NP route now and was previously deeply confused!! Still undecided if I want to get my BSN before my MSN.
The problem is that most of the time the patient does not have a choice. Nowadays, when you make a doctor's appointment, you are most likely scheduled with a PA or NP. I don't have a problem with either as I have worked along side them for many years. I just think that if you are told that you must see an NP or PA because of scheduling conflicts and you can't see an MD, then you should not pay the same price. Insurance companies, Big Pharma and medical facilities love PA's and NP's because they are able to charge the same for services and they keep the number of prescriptions written high which results in huge profits. There are about 179 medical schools in this country and 400 nurse practitioner programs. Something is definitely wrong with our healthcare model when the number of graduate physicians are far less than graduate PA's and NP's. There needs to be more of an effort to decrease the costs of medical school and incentivize people who possess the intellect to pursue medicine. An NP or PA were never meant to replace MD's but that seems to be where we are going because of the shortage of MD's we're currently experiencing.
i agrée as a high school senior i want to be an anesthesiologist but i keep seeing the stats of mes school and residency and i think about how i will barely have time to live my life and start a family and it’s all so worrisome. imagine if after all that you don’t make it into med school and even if u do u might not make it into residency
Pre-Med student here and while I know pre-meds don’t know much outside of Mitosis, I have been an Advanced EMT since high school, and I have worked in primary care clinics with many MD, DO physicians and also PA and NP’s. I have chosen Pre-Med and MD because I know I want to go into trauma surgery and at the end of the day PA, and NP’s will never be surgeons. However if I wanted to work I. Primary care clinics I would 100% choose PA and NP because less training, less debt, and much less effort in training. The MD’s I worked with always got patients passed from the PA’s because of the increased knowledge when we had something that wasn’t textbook. It all comes down to what will make you happy? I know I love healthcare and I could work in surgery as a PA but I would never be the surgeon and that isn’t enough for me!
That is what I am trying to decide too… I would love to perform plastic surgery but I am already 29 and I already have a bachelor’s degree and I was thinking to apply to be a MD but it would take me many years and I would like to get married and have a family by 35 hahaha 🤣
Knowing the scope of practice, is also knowing what isn't. A Primary Care Doc will refer to specialists once a patient's concerns might be out of their scope of practice. NP's do the same. Practicing independently doesn't mean that an NP can take care of every condition, it means they are independent professionals. There are current states that allow NP's to practice independently. If the concern is patient safety, then it seems a simple matter of looking into patient outcome data from those states, compared to states where NP's are supervised.
A proficient primary care doc should be able to manage and work up conditions to an extent. i'm willing to bet that a majority of physicians would be able to manage more conditions without sending the patient to a specialist which costs the patient more time and money but someone with vastly less training would have a lower threshold for referring to specialists.
@@Benboy887 Why would a general practitioner"manage and work up" conditions out of their scope of practice? This sounds like your own fiction and not reality.
@@cathiehealey4608 They would manage and work up conditions to know what they are consulting for in the first place. Additionally, if it turns out to be a condition that is easily treatable and the person doesn't have a complex medical history then referring isn't necessary. It isn't own fiction, it's what was and SHOULD be the case but PCPs have become more referral generators with midlevels being the worst perpetrators. Many of the specialists I have worked with have said "I'm happy to see this patient, but they could be easily managed by their PCP."
@@Benboy887 That's fine once they're seen by a specialist. Just because they're seen by a specialist, it doesn't mean they have to have the condition managed by the specialist after they diagnose it. f it's an uncomplicated, chronic condition, then a PCP (no matter the initials after their name) can manage it. That doesn't mean they shouldn't have been seen by a specialist. If the specialist sees it hundreds of times a year and a PCP see's it once a year, the specialist should be diagnosing it. It's out of the PCP's scope of practice. Just seems like you're working pretty hard to create a situation that may or may not happen. Everyone has a scope of practice, and everyone is expected to practice within theirs.
@@cathiehealey4608 I get what you mean, that is certainly the case when someone is referred for something enigmatic. However, I mean I personaly knew a NP that has been a PCP for years who referred an elderly patient to a urologist for a single PSA value slightly above threshold and the urologist was like, "I'm not sure why you're even here, we trend these values." Never saw a physician refer for a PSA like that while I worked at that clinic for over a year I worked there. All I'm saying is, an MD/DO will be better able to manage those conditions than a midlevel and would likely be able to determine is something is worth referring or not. It isn't to say that the MD doesn't over refer, but it is much less likely. And many physicians I've worked with in my area during clerkships have complained about bad referrals from midlevels. It's a meaningful phenomena. Scope of practice is broader for a MD/DO in the primary care fields. It should be much narrower for NPs/PAs as their training path is not comparable and so their scope of practice is narrower.
As an urgent care RN I work with all the above - MDs, NPs, and PAs. I can definitely see a difference in their training especially with emergent cases. However, there are incredible providers from each of the respective backgrounds (and also terrible from each as well).
One thing with NPs, most of them have been a registered nurse for 5,10,15 years etc. So they come into NP already with a ton of knowledge, hours, experience.
As someone who has a bachelor's in biology, a BSN, a GPA of 3.84 and experience both as a practicing nurse, and in an epigenetic research lab focussing on fundamental nutrient pathways and reproduction; the way you degrade NPs and PAs in this video is astounding. I have made the decision to pursue midwifery practice as a nurse practitioner program (DNP), not because I was afraid to work hard (or have poor GPA) as the video implies, but because the model of care better aligns with my values. I fully intend to open a private practice as an NP. The decision is not because of a capped pay, or because I have more time on my hands to lobby for it. There is a need in my community. If filling the need means some pompous guy on TH-cam labels me a scope creeper, so be it. 😂 The goal of competency and high level functioning in a field should never be restricted to only one path of learning. Yes, physicians may come out of medical school with more knowledge than a graduating NP or PA. However, if you believe that means that they perpetually maintain superior knowledge than everyone in other fields, you are delusional.
As a RN I will not invest the money or the time in becoming an NP. It's not worth it. It will not be much of a salary increase especially when I travel. Many of my travel nurses make 150-170k (low end) a year doing fulltime traveling just as a nurse and get to explore new areas.
My aunt became an NP. The only reason she made that leap is her employer covered her education expenses 100%, otherwise she wouldn't have just for the extra 10-15 grand a year in her area.
@@bluejedi723 I bet that came with work commitment lol Maybe 5 years. Most hospitals wouldn't even pay for BSN without work commitment. 10-15k? That's so low for carrying so many risks and responsibilities as a provider.
Really?? What was so important to discuss?? You already made your choice right? Wasn’t the point of this video to “educate” others on each career path??
These are so helpful thanks for making them! If I had seen this sooner I probably wouldve chosen a PA path admittedly lol I didnt meet a PA till I was a junior in college, deep in my Pre-Med track Now, I'm a 4th year medical student (4 out of 7yrs in Havana, Cuba) and feel fulfillment with my choice and values but I sometimes wonder if I had been introduced to more critical career thinking and taught about prioritizing a healthier work-life balance if I would've still gone to medical school. Admittedly I do think the biggest perk is the opportunities and income attached to an MD career (and people still are still much more preferencial to the "Doctor" title when seeking care which to me is an "accessibility perk" to the populations I wanna serve) - but then you can still do alot of good work and be a good person without the traumatic drama of glory? It's really up to the individual at the end of the day.
@@qwq2170 im on scholarship specifically for americans who want to study medicine in Cuba. Without this I would absolutely be in crippling debt in the US because medical school scholarships are basically nonexistent and the total cost (paperwork fees, scrubs, textbooks, etc) continue to rise. I recommend really studying between PA, NP, DO and MD career choices and if you really want MD try to secure as much family/community support, Grants and outside scholarships (from foundations or wtv). If you're interested in my med school lemme know. Otherwise hope that helped and best of luck!
@@ayrang25 damn that’s unfortunate how scholarships for US medical schools are lacking. But nonetheless I really appreciate your answer and I’ll reach out if I have any more questions. Thank you :)
I am a FNP. I did 5 years to become a RN. Before applying to NP school you need one year of med-surg and one year of critical care. Then NP program is 3.5 yrs at Pace University. Then, pass boards. NP must do clinicals at the same time of didactic work. Patients prefer NP because we take more time doing our physical exams and since we trained to be excellent communicators, patient trust our care.
I hear praise from nurses to be a NP because you have to actually be a nurse first and go into the tranches to serve people. Most doctors they have worked on the er tend to be clueless and often have the head nurse take over. I’d say patient exposure experience is superior to diddling with your pen with 10 textbooks experience
Until something is done both about the debt burden of medical school AND the fact that around 8% of medical student will not match into a residency because of the residency shortage medical school seems like a serious gamble even for those who are interested. Also, it’s crazy to me that the NP’s had a higher average salary than the PA’s.
Good point about medical school debt. That's one of the many reasons why I declined my medical school acceptance. As for the NP and PA salaries, they are similar. They aren't that far off. If they are far off, it's usually because of a certain specialty route (which PAs can also choose and make more money).
PA Programs are Master's Program with more and more doctorate programs creeping up. When I was a practicing PA I always felt most comfortable with an M.D. near by. ❤
I wanted to get into medicine to be the expert in what I am passionate about. That requires the most education and training available, which would be the physician route. PA's and NP's simply do not receive the amount of education and training to be considered equivalent, no matter how they will try and spin that they know "just as much if not more" than physicians. This wouldn't fly in any other career field so I'm not sure why healthcare is so loose with their training requirements. A flight attendant wouldn't be allowed to fly the plane if they shadowed a pilot for 500 hours so why are NP's allowed to practice unsupervised after minimal clinical training in NP school?
The reason why it's occurring in the medical field is because of physician shortage (which is mainly due to how unattractive the physician route is becoming). PAs and NPs are ranked as some of the best jobs in the US according to USnews (#1 and #3 respectively), and they still make a lot of money (PAs usually have a higher net worth than doctors until the mid 50s) and don't have to sacrifice their 20s and 30s to residency and med school. So unsurprisingly, more and more people are either not going into healthcare or becoming midlevels rather than doctors, which is why hospitals are eager to hire them. As a bit of a sidenote, I do think the analogy of flight attendant to pilot is a bit unfair here (at least for PAs).
@@adr77510 You are 100% incorrect. Med school application numbers and stats are higher ever year. US News is largely a flawed reporting outlet, with subjective views based on their main audience. You are also incorrect about the net worth of physicians, most by their early 40s are pretty secure, granted they don't spend their attending salaries like idiots. Lastly it is very inappropriate for anyone to make the assumption we give up our 20s/30s. TMed students are some of the most talented people; who know how to balance their lives. I've had many friends that got married and had kids in med school, explored interests and hobbies outside of medicine to the fullest extent, traveled the world, etc. Becoming a midlevel is hella easy, at least for any person who can get into med school. Hospitals are hiring them because they're cheap labor and the ones running hospitals are MBAs. The analogy is great. I have multiple PA friends that know enough to do bread/butter but don't have any depth of understanding to the why. PAs have a role in medicine and when they work collaboratively with physicians, it is very beneficial to patients.
@@studyingandstuff435 med school applicants are rising every year, but there are still far fewer applicants for med school rather than for law school or business school. I don’t know where you heard US news wasn’t a good source, because it’s overall considered very reliable. The net worth part is true too, and is explained pretty well in Dr. Juballs physician vs engineer video, in which he shows that engineers (who make around 80K) have higher net worth’s than physicians until their mid 40s. PAs and NPs both start off making 6 figures so that number would take them into their mid 50s. That’s not because physicians aren’t financially secure by that time (they are already well off by 40), but rather because midlevels are even better off. And I do stand by the fact that you have to sacrifice your 20s to healthcare. Med students have told me that they rarely have free time and that they are either busy studying or researching. Residents have it arguably worse because they can stay in the hospital up to 26 hours straight. Compared to med school, PA school and NP school are both considerably easy, which is another reason people choose that path. PA school though is still no walk in the park and isn’t easy to get into either. I do agree that hospitals hire them because they are cheaper to hire, but they wouldn’t be given the opportunity to if their were a surplus of doctors And the analogy, at least for PAs (I see the logic for NPs), is incorrect. Flight attendant to pilot is like nurse to doctor. PAs are given a medical education rather than a nursing education and are taught to do the bread and butter (nurses aren’t). NPs are given a nursing education so the logic applies for them.
@@adr77510 a lot of what you've been saying is wrong but lets just focus on how wrong your net worth numbers are LOL. if you're comparing a family med doc to the midlevels. Fam med takes 11 yrs compared to PA/NPs 6-7 years. Average fam doc salary as stated in this vid is 240k, avg PA/NP salary is 100-110k. So assuming starting from age 18, fam med doc starts getting paid age 29. PA/NPs start at 24-25. The PAs/NPs have 4-5 years of income more than the fam doc. Lets assume the maximum amount of 550k and ignore taxes. Now if the fam doc makes 130k more per yr than the PA/NPs, how long does it take them to erase the difference...550/130= 4 yrs 3 months. Age 33. After age 33, the fam doc more than doubles the PA/NPs money to the bank. By age 45 (since you referred to mid 40s), the fam doc has made 1.5m more than the midlevels. By age 55 (since you referred to mid (50s), the fam doc has made 2.8m more than the mid levels. Substract their ~200k school debt from their millions. Tell me again how physicians would take until mid 50s to catch up Lol. Also half of doctors are specialists, avg salary as stated in this vid 340k. Residency slightly longer for the less lucrative ones and much longer for the more lucrative ones. When Spine surgeons rake 800k / yr, how fast do you think they catch up?
@@adr77510 Looks like you're getting attacked by a lot of hyper neurotic Premeds. Your points were well articulated and non argumentative. Just thought I'd throw that out.
In my opinion if APPs want independent practice they should have to complete a full length residency equal to the standards of physicians and then everyone takes the same specific specialty's board exam
@@shlang23 I don't think so, they would still go through their respective post bachelor education programs (PA, NP, CRNA etc) but to practice independently they would have to complete a residency of equal standards and then prove their knowledge competency via the specialty's board exam. I wouldn't have any issue with independent practice after that. I would even support equal pay
@@mattgehm7827 No if you want full practice authority you go to medical school. Midlevel schooling not even a fraction as rigorous/comprehensive as medical school. Medical school + Residency= Physician. There's no shortcut when peoples lives are at stake
@@cubsfan708 well really med school= physician if you want to be like that. And I'm not egotistical enough to say only physicians can have independent practice. I think in reality it's the post medical training education that makes someone a provider. If APPs were to complete a residency of equal standards and then take the same specialty board exam as a physician I would have no problem with it
@@mattgehm7827 I apologize I read my post and came off as a dick. I dont think its about ego but about having the most capable providers. I think it would make more sense for the AMA to lobby the government to increase funding for more residency seats. I also think the government should provide more loan forgiveness programs and incentives to Doctors that decide to work in rural/medically underserved communities. This would be much better than increasing scope of practice for midlevels.
Certified wound care nurse here. Almost done with my Master's and then will go for NP. I've seen this topic debated for so long. I work with so many NPs, PAs, and Physicians in a large academic medical center. Honestly, patients mostly don't care who's treating them as long as they're being treated with the best care. I don't feel that these professions are "better" than the others. As this video mentions, it's just what best fits the needed role and your preferences. I recommend to Physicians the best evidence wound care and they respect me and listen because they know I am the expert on that topic, however I 100% respect and recognize their immense knowledge and the things they do that I can't. That yields the best outcomes. Yes, there should also be room for some change. Maybe there are more things that NPs and PAs can do on their own and they are lobbying for that, but that also ultimately helps Physicians so they can focus on more complex cases. I feel like the mindset should be to be the best in whatever your role or profession is. The best NP/PA at their peak is going to do more for patients than a Physician who is not practicing at their best, and vice-versa. In the overall view of healthcare, we are all a team and we function best that way!
From this video I realized it is really hard to be NP here in Canada. You must have 3 years RN experience (5000 hours to be exact) and 3.5 GPA Minimum for most institutions. So it takes almost 9-10 years full time.
Unless it's for something simple, I always see a doctor over an NP (never seen a PA before, never had the opportunity). NP's don't receive the same training on disease-related illnesses that doctors do---this means that an NP is going to refer you to a specialist, where as in many cases, a doctor can diagnose the disease with things like bloodwork, and can write a prescription on the spot
I’m going to NP, since I’m finishing my BSN at 41 yrs. however, I understand that I won’t be neither qualified nor trained as a physician, and yes, I don’t mind working under a supervision of a physician.
Current PA student here: 1. My argument for greater scope of practice is solely so that my future supervising MD/DO has the legal ability to entrust me with greater and greater responsibilities. If I've trained under them for years and they feel I am qualified to handle a certain procedure, I believe they should have the legal standing to do so. 2. I feel it is ABSOLUTELY dangerous for NPs, especially those doing the direct path, to be allowed to open independent practice. Us mid-levels just straight up do not have sufficient training to do so. That's not the point of the job. You decide to become a mid-level because you want to care for patients under a supervising physician. If your dream or goal is to be autonomous, then you go to med school. It's simple as that.
This. Unfortunately whenever the discussion of "scope creep" is had without a PA, it fails to recognize that the vast majority of PAs understand that our role is to practice medicine alongside a supervising physician. PAs generally understand that their training does not qualify them to practice entirely independently in any specialty. Most of us find NP lobbying for independent practice incredibly dangerous. Also the AAPA is not great at lobbying. Our numbers are so small compared to the nursing lobbies and we don't have time in PA school to take a class on lobbying (an actual course in a many nursing/NP programs) since we're busy studying medicine. That being said, there's potentially great benefit to reducing the administrative burdens involved in hiring a PA and maintaining strict requirements between a PA and their SP. It's unfortunate that while NPs lobby for full practice authority and are gaining it in some states, NPs are preferentially hired simply because they're easier to hire. I hope people stop lumping PAs with NPs in this discussion. We'd have a much more productive conversation if that was the case.
The issue with FPA for midlevels is that even if you get greater scope of practice just for your situation, it will be exploited by companies and hospitals to save a quick buck at the expense of patient safety. We're seeing it now with various hospital groups firing physicians and hiring many more midlevels. It just isn't worth it.
It’s idealistic to say that the supervising physician will determine how much responsibility they trust you with. In my experience, admin is setting up staffing so there’s not enough doctors and then mid levels are told they need to pick up the slack which means going beyond their scope.
Pretty accurate, I mean we’d be kidding ourselves to say that there isn’t a tad bit of bias (lists out undergrad years for med school [in a nice linear fashion] but only graduate years for other routes 🤔) but he is absolutely right in respect to the rigor. I honestly respect anyone who has not only made it through residency but also a fellowship. On a separate note, when talking mid level creep, there is a world of difference between an NP program and a CRNA program, both in terms of competitiveness and rigor. In addition a CRNA is trained to do one SPECIFIC job, not as a generalist to fill any number of roles. No disrespect to my NP colleagues but they can’t really be lumped together.
All NP's are trained for one specialty. There are Psych NP's, Family NP's are trained for primary care, Nurse Midwives, are NP's trained to care for pregnant women and newborns, and CRNA's are nurse anesthesists. As compared with the PA Model where they're trained as generalists.
I noticed that too! He left out the undergrad for PA and Nursing but then listed it for medical school as if to say that medical students have 12 years of experience while a PA has like 4. That’s not true, a PA has four years of undergrad and four for for PA school
Look before you jump. Many of the better PA schools only ACCEPT between 4% to 8% of the people who APPLY to the school in a given year. You may have to apply to a large number of schools, perhaps some not-so-good ones, to get into any of them.
Most docs don't give enough cred to the FM docs. Heck, speciality med I think is also trying to limit the scope of FM docs - trying to make them irrelevant.
i am literally in tenth grade and i’m just stressing over if i want to be an NP or a MD, i love the idea of clinical hours and all of that stuff but the burden of medical school seems so overwhelming
@@yugnok okay, wtf? healthcare is my passion, we need doctors and nurses and PAs in this world. just because YOU don’t like it doesn’t mean no one else should. let people do what they want to do. i’m willing to go on the path that i need to take to work in healthcare.
Omg me to I am in my 10 grade i dont know if I should choose bw pa or np or md . But trust me u will know after 12 anyways so just keep studying science well . And don't listen to PPL who are telling u don't go to healthcare , do what u can do . And u will see u will do it . Hope u ganna become what u wanna be in life bye have fun.
Go to a community college for your first two years to prevent taking out loans. Pick a major that you know you'll get A's in and take the requisite pre-med courses as electives and work hard in those classes.
Just like it's mentioned in the video briefly, for NPs, we have to choose the specialty before we apply for the program. I'm a psych NP who finished 3 years of psych training (1 year of clinical rotation only in psych- some programs require more than a year). If I ever change my mind and want to practice as a family NP, I have to go back to school for family np program and take a different Board exam. While my husband chose to be a physician, I chose to be a nurse practitioner, and I have no regrets! I believe everyone's path is different :)
You won’t have to complete a residency to change specialties. One year of working under a different specialty for 40 hrs a week is nothing compared to working 60-80 hrs a week for 3-7 years
@@yallamafez2428 I was simply explaining how the NP program works since not many people know about NP programs. Did I ever mention that NP programs are equivalent to MD/DO residency programs?
I feel like you failed to highlight the patient care level of each practice. Typically a NP has worked as a nurse for many years and has the most patient care experience. A MD usually graduates with nothing other then their residency and has absolutely so empathy or regard for patient care.
As it should be. PA and NP are just nurses, who think they are doctors. It is really dangerous precedens and really making all that study and work that doctors obtain as useless if you can just do a course and you will become kindadoctor.
This video really seems to try to talk people out of going to medical school. I know in the Netherlands (where I live) getting into medical school is really hard (it took me a total of four tries, spread over 2 years, as an above average VWO student). However once your in, you get three years of intense (but extremely interesting) theory (I am in my second year) and afterwards you get three 'clinical years'. After that you also need to specialize, but most of these already pay and they pay relatively well (1200-5000 euros per month). So I think in the Netherlands once you get in, are motivated and understand it's hard work a lot of the problems pointed out here aren't that bad (only six years of medical school and three of them are purely theoretical, costs are relatively low and if you want to switch your specialty it should be possible). The only thing I know is it's incredibly difficult to get into 'specialist tracks' to for instance become a surgeon or a pediatrician. Meaning that if you are average in medical school you will probably become a general practitioner or a psychiatrist. But I'll see when I get there
I know a NP that claims they know more than MD and is better than PA which baffles me. Good to see in comments that other PA or NP dont think this way.
The biggest hurdle for me to get over is how the 20,000 of residency is heralded as the qualifying distinction (which I can understand), but the years of clinical practice that a nurse has are completely disregarded. Before someone criticizes my point, yes I understand there's a difference between residency and on-the-job practice. I also understand that there are different standards.
The clinical practice of nurses is different than the work of residents. They aren't building differential diagnoses, studying pathology and treatment, and as you said, have different standards. They are totally different jobs and the responsibilities of nursing while good skills to have, but do not necessarily build the skills for medical practice.
@@Benboy887 I agree, totally different worlds. That nursing is nursing, a totally different career which has always been nursing with different purposes. It never included the end goal of prescribing, knowing pharmacokinetics, pharmacodynamics, side-effects, biochemical paths of medications and treatment, the why a medication with its pharmacological effect would work on this or that condition because of the physiological pathway involved in its mechanism of action over the body... it is not shading nursing work, it is just that even lots of experience as a nurse does not equal the nature of the training and experience of a physician because they were both trained in very different terms and for different purposes. I would say PA is more oriented as a second hand for clinical practice for a physician since their training is even shorter and is more focused on medical sciences.
When I was in the Navy we had Independent duty Corpsman. As the name implies they work very much independently from a Dr. I was on a submarine so they were very very independent. They were also very very highly training and capable (many times I preferred seeing the corpsman over a DR. They could every do certain types of surgery. But they also, knew when the medical issue was out of their scope and had no problem arrange for the appropriate level of care. The ironic thing is when they get out all that training is for naught. They basically start over. Although I have hear there are efforts to change some of that.
I see many people mention the medical model vs. the nursing model but never explain the difference. CRNPs follow the nursing model yet can practice independently vs. PAs following the medical model and some not able to practice independently. Can someone offer some clarity here?
I was recently checking out med schools (hoping to start in 3 years) I found some programs that had 3 year programs! And they have some kind of special residency(3y med school only for Fam, Int or peds) or can pick from a list of specialties that school. Could you do a video about these types of programs please? For anyone wondering there are only about 15 I think? And they basically just condense the 4 years by skipping summer break. They also seem like they are more specific to the specialty you want to go into.
I’m interested in primary care and I’d love to see a 3 yr med program as an option at more DO schools. For a variety of reasons, I’m only applying to DO schools
These schools do cut out the first year summer and the 4th year that is used to do residency interviews considering that you are not competing with anyone and you already know where you are going and virtually have already been accepted. The concept of a 3 yr program is gaining steam due to students complaining about cost and the value of the 4th year.
![So You Want to Be a PHYSICIAN ASSISTANT [Ep. 17]](http://i.ytimg.com/vi/IyZCMcq4zVY/mqdefault.jpg)
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![NP & PA vs MD & DO | The Scope Creep Controversy [Research Explained]](http://i.ytimg.com/vi/Ow5N9jXJ-_A/mqdefault.jpg)
PA Student here! And in all honesty, this sums it up exceptionally well. I went into PA school because I'm personally fine with working as part of a physician-led healthcare team because I'll still be leaving a positive impact on the lives of patients. I don't mind taking a step back and dealing with the "bread and butter" of medical care. In my pre-PA experience, the PAs I've worked with always enjoyed working very closely with their supervising physicians. Even now (in my program at least), we're all very well aware that we aren't at the same level of depth as our physician colleagues. I have zero intention of seeking independent practice nor do I think that my current training will ever equal that of a physician's. Hoping to throw this out there to show we're not all engaging in scope creep.
Much respect to you
Deciding between wanting to go to PA or NP school. Is PA school like crazyy difficult? Ik NP don’t follow the medical model so NP school might seem less stressful,
@@HannahTran1 Well, to be honest, neither NP or PA school are easy. It may statistically be less competitive to get into NP school than PA school, but both will still challenge you. The nursing model doesn't necessarily make learning the material easier. The NPs I've met who worked as Nurses prior to their NP training can definitely attest to it being very stressful (although many NP programs do allow you to work part-time as an RN while attending). I wouldn't recommend going to NP school unless you've had at least 4-5 years of full-time nursing experience, that was the initial purpose of the NP profession I believe, to build on a nurse's prior experience and advance their practice.
As a PA student, I can say that although it isn't as in-depth as med school, it is still A LOT of memorization and studying. It's basically a full-time commitment and you'll definitely be sacrificing a lot from your own personal life and won't have that much free time. PA School basically tries to cram as much of the basic foundations of medical practice as it can in 2-3 years. I can't speak for NP school, but PA school covers all the specialties of medicine whereas I believe an NP program will emphasize the specific specialty that you chose (i.e. Family Medicine, Pediatrics, Psych, Women's Health).
For a TL;DR: Yes, PA school is very difficult and takes up a lot of your time. Lol. But, I wouldn't necessarily say NP school is "less stressful" either.
-Hope this helps :)
Very true, in fact, MOST PA's are in your boat.
Couldn’t agree more! You don’t see much positivity written under this comment… but you see lots of negativity written under the comments of other PA-S’s and other mid level providers/students who felt disrespected! The idea of scope creep is definitely real and as a PA-S myself I feel that more NPs are trying to work independently in a specific field like an MD (and have successfully gotten that independence) but ALMOST ALL PAs know their role in healthcare and especially in surgery as a first assist! This video lumped all mid level providers together in a way that was misguided and not as informed regarding legislation and without ideas of what each mid level professional organization has been lobbying for (PAs = optimal team practice, more direct pay from Medicare, team of review board PAs instead of MDs while NPs are actively fighting for their aforementioned independence). I have watched this creator’s videos for a long time and love their work on study habits and different specialities but their lumping of mid level providers and non clarification of their intentions was a little off, as well as his discussion on “doctors being too busy to lobby for the AMA” (insinuating that PAs off work spend their time lobbying and not with their families/side hustles) was a little demeaning. I will continue to watch his content as he’s a great creator but needs to be less biased while curating videos like this!
Being a doctor is because you love to serve and make fast decisions to save lives. I gave up everything to be doctor I’m yet to regret it regardless of the difficult path. It’s a passion that I will repeat over and over again without thinking twice.
I am loving the dip into the non MD fields. As an x-ray/MRI technologist it makes me excited that one day you may find the time to make a video on the technologist/technician/assistant fields.
Yeah! Radiologic Technology is a great field!!!
Im actually convincing my nephew to study to become an x-ray/MRI technologist.
@@MayISpeak Hope he goes into it! The school is fast paced and difficult to consume at first but it is absolutely worth it. Every hospital needs more technologist.
I am a PA, and the comments on here by other mid levels baffle me. Lol. If you want to be autonomous without jeopardizing patient safety, got to medical school and complete a residency. I am in a PA Emed residency (18 months), and boy am I glad I chose expand my knowledge and continue learning in a supervised environment. Seeing MD/DO interns shitting their pants when a DKA patient with underlying urosepsis presents to the ED and requires pressors reminds me how Important it is to have thousands of hours of supervised training. Think patient safety, not useless titles.
Thank you MSI, great video!
how long does it take to become a PA right after high school? i’m a senior and i want to be a PA but considering doing working RN then NP after experience instead just to be able to provide for my parents while I can
Tbh why would anyone ever want to practice autonomously that’s someone’s life on your hands wouldn’t you always want a second opinion lol
@BriannaOfficial I have to second that. As a resident I was so happy that I had an attending with years of experience to bounce my opinions off of until I felt confident enough to do it on my own. So it mind fucks me to think that I felt that way, with significantly more training than a PA, but here come these 28 y/o fresh out of PA school thinking they are some hot shit, lol.
@@oeowowowowiei6412 Im in medical school (MD/DO), but I know a bit about the PA track! First, you must complete a 4 Year bachelor’s at a university and make sure you have met all pre-reqs for entering a PA program regardless of your major. There is also a required amount of clinical hours you must achieve before you apply, which differentiates PA programs from MD/DO programs (many of us do have clinical hours upon entering medical school, it’s just not a requirement like it Is for PA school). It’s a pretty substantial amount, so I know many people will take a year or two working as a medical assistant or something before applying to PA programs. Then your PA program Is 3 years long. Residencies/fellowships are not required nor expected for PAs like they are for MD/DO so you are able to practice/find a job right after you graduate PA school. So, realistically, you’re looking at about 7-9 years post-high school for PA vs the minimum 11 for medical school (MD/DO).
@@OuchinessThe two aren’t mutually exclusive.
I left the medical track for nursing when I realized that I wanted to be a mom more than anything. No disrespect to my MDs and DOs out there. Y’all are some of the hardest working people I know and I value your clinical expertise. It just wasn’t for me.
That’s kind of my boat. I’m 24 and having a family and free time to travel when I’m young are so important to me. I feel nursing will give me that life while still helping people. Though being a doctor does have appeal bc I like being in charge! Lol
@@khaleemaalkainaat8178 if that’s the best decision for you, and you truly love what you do, that’s awesome! Just here to say you can have all that and apply to medical school! I didn’t even apply until I was almost 25 and made it a point to travel and have fun before then! I literally had to fly in from South Korea back to the US for my interviews lol signed up to do one of my electives for a month in DR for my 4th year, and have been to other Caribbean islands coming up 3x in March since being in medical school. I also know people in their 30s in my class married and with kids. Nursing Is an amazing profession, and it absolutely allows more flexibility; but you can find ways while pursuing your MD too.
@@sydneyoneal7463 may I ask what profession you had before applying to med school? I'd love to travel before med school but I'm not sure what I would use to sustain the costs
Finding this thread a bit late but just wanted to point out that you don't have to eschew med school if you want to be a mom. I'm a 4th year student at a great MD school and I am married with 2 kids. It's definitely not a cakewalk and you have to really want both things in order for it to be worth it in my opinion.
@@LaurenMichelleMD you have probably one of the oldest created accounts on TH-cam. It’s rare and also great to see you’re still active just very recently!
I'm a college student, and like many other people, I have to learn everything on my own because I never learned about this. Sometimes, I just need a helping hand and I really appreciate you explaining everything so nicely. It was very clear and to the point, and you have a great narrating voice (not the monotone voice). Thank you for this explanation.
As a young NP I felt I did as good a job as a Physician. Now as an older NP, we definitely have our limitations. The training is 100% not equal.
Hello! this is a big ask but i was wondering if i could contact you privately about your job and what you enjoy and dislike about it as i am currently in education aspiring to be a np Thank you!
Being a physician is a noble passion and a calling. Requires a lot of hardwork, dedication and years, NO SHORTCUTS. I’m happy, fulfilled, occasionally stressed but will study medicine over again if I have to. ❤️
your right
I am very happy with my decision to go the physician route.
We all are too
I LOVE YOUR CHANNEL!
I've worked for a psychiatric hospital for 28 years and never really understood the difference between a PA and NP because they appear to do the same job. This video was helpful.
Until MD/DO schools get cheaper, or primary care physicians start getting compensated appropriately, I don’t see the primary care physician shortage decreasing. The people suffering because of that are the patients, because they deserve well-trained, talented physicians but fewer doctors can afford to go into primary care after med school because our loan payments are so extreme.
NPs do just fine for primary care. I am not sure they’re suffering because a lack of physicians, but rather a lack of access to healthcare in general. Trying to prevent NPs from helping is a mistake
@@ThatGoodBarbequ Nurses don't get the same education as Doctors so they can't do the same work
@@memali2939 depends on the specialty. Both my primary and psych providers are NPs, and I’m fine seeing a NP/PA in those specialties. Both providers are knowledgeable and spend a lot of time with patients. On the other hand, I prefer to see a physician for more complicated specialties like ENT and GI
@@ThatGoodBarbequ NPs have inferior education.
@@ThatGoodBarbequ NPs do not do fine for primary care. Their training is greatly inferior. They completely miss rare conditions. They often every child that wheezes has asthma leading to frequent misdiagnosis and unneccesary medications. many can't even treat a common cold properly prescribing steroids, inhalers, and antibiotics when most of the time none of those are required.
As a PA none of this matters. I function independently in a rural community. No one wants to work rural healthcare. We will happily take an MD, DO, NP, CRNA, or PA any day. People need care. There arent enough physicians especially in primary care. We didnt make it that way, we are just trying our best everyday. We have to practice at our highest scope of practice out of necessity. Just like community health aides in Alaska. So we are waiting for you no matter what path you decide.
I'm in my BSN (graduating next year) with intentions to get my MD/DO. Many of my nursing professors are NPs and are very transparent about how different it is from being a physician; primarily, they felt way less prepared right out of NP school and had to work extra hard to be knowledgeable. That increased their anxiety, exhaustion, and depression, especially working alongside residents
Thought about this, then I remind myself of the mountain load of debt lol.
@@deansamuels2247 when you’re making 300k+ that debt isn’t the end of the world. It’s an issue if you go to the most expensive med school out there then end up going into a field that pays below 200. I finished with 300k debt and first job paid 410k. I’m not stressing about payments 😂
Some NP specialties such as Neonatal or psych prepared you very well before you graduate. Higher income comes with higher taxes don't forget that. Anyway 300k is not bad for medical school, but alot of ppl I know owe more than that for medical school and they may not match into high paying specialities. You can look into scholarships though.
@@intergratedmedicine4538wow. 410K as a physician?
That’s everyone tho. That’s why residency pays so low. You don’t know anything yet
Gonna be a doctor, this is my first year at faculty of medicine... so excited!
how’s it going?
I considered all... but ultimately I chose doctor all the way (even if it was a nontraditional path!)
Which med school did u go to?
I’m a non-traditional premed who is planning to apply to DO schools. Very excited about my future career path!
@@lauraeager373 you got this!
@@lauraeager373 I'm excited for you!
@@lauraeager373 good luck! - DO school graduate
Truthfully I think being an MD makes less sense every year unless you want to do surgery or just want the status of being called a doctor . When you look at the 8-15 year commitment, the cost of school , the lack of flexibility once you specialize, and lack of sufficient pay during residency it becomes abundantly clear which path most people are going to choose. Med school has become more about draining students wallets than training well educated physicians. PAs and NPs are well compensated right out of school and don’t have to put their family lives and lives in general on hold until their early to mid 30s. If we want to fill the current void of primary care doctors then something about the MD pipeline is going to have to change pretty soon.
Definite pros and cons to each path
If you wanna know wtf you're doing become an MD. NP and PA is for people who wannabe docs but are not willing to put in time commitment to be competent in medicine and looking for short cuts
Nah, I’d rather just not be 30 something to start paying off my debt properly. I’d also rather start a family earlier, buy a house earlier, and live life :)
@@lolalolalola3801 that’s a very arrogant way of thinking, they’re obviously different roles and I don’t think there are very many mid levels who would disagree . The idea that you cannot be “competent” and be a mid level is also silly.
@@epicwin2513 sure, you're still a midlevel and not fit for independent practice
As an NP, I think there are two major problems with the current way of training. The first being that some schools do not require hours of work as an RN prior to entry.. how is that possible? The second being that the masters and doctoral programs are not a clinical focus, but a science theoretical focus which does not help for the actual job.
Wow. Very rarely do I hear this stance from NPs, but this is exactly the problem! Thank you. The fact that so many NP schools are now just looking for anyone that can pay tuition is watering down the field, and then those same people, without the RN experience, without the "smarts", are lobbying to practice independently. It's a money grab. Period. And it's dangerous! A well-trained NP is indispensable to the medical profession, but an ill-trained NP is a danger to all!
@@dr.deniece6399 I agree. I think NP's have so much continued potential if only all programs had an admission standard & were better optimized in terms of their masters/doctoral time to be more clinically focused. I'm in Canada which has a higher admission standard than US schools - but the overall problem is North America wide.
I completely agree!
My DNP education was solely clinical and not a PHD.
I also had to have at least 5 years Acute care experience
Been watching since the “How to study better video four years ago” when I was still in high school. I’ve learned so much for the profession I strive for here (MD/DO). Keep up the good work!
S
It’s important to learn how to study. I never knew how to study nor did I have to study growing up in school. Learning medical knowledge it’s important to understand instead of memorize for critical thinking. I struggled whenever I had to rely on critical thinking because I wasn’t understanding and learning. I was studying to pass exams instead to understand how to apply them. It took me my whole tenure to understand finally how to study. You got a head start so you’ll be good!
@@Travisej2sorry I’m a year late. Thank you!
NP student here. This video is basically sums everything up. Chose NP because I know I do not want to sacrifice my 20's so I am basically prioritizing lifestyle.
How many years of nursing did you do before NP school?
@@thejasosei for NP you need to be BSN??
@@jiya5423 yeah. you have to get your bachelors first and get some experience in nursing before you can get your masters in it to become an np
@@thejasosei okay!!
What is diff between DNP/MSN??
@@jiya5423 your msn is your masters of science in nursing. you can get this after your 4 years of undergrad. some people get this degree just to further their nursing education/make more money at work, but going to NP school results in getting your MSN because you’re getting your masters. A DNP is doctor in nursing practice, some nursing specialties require this but it’s mainly a way to further education and be rightfully named “Dr. _____” even though you’re a nurse.
Thank you so much for making these and breaking down the various career paths. As a 34M who’s hates his career in tech, the idea of switching to healthcare is absolutely overwhelming, but it’s something I want to do!
Have you looked any further into getting into healthcare? I’d love to hear an update! :)
Ooh, I’d also love to know if you decided to pursue medicine. I’ve been in the healthcare world for a long time and was trying to make the switch to tech, but find the doors closing often. Thinking it may be a sign pointing me to stay in healthcare.
NP here. I had 15 years of RN experience before I became a NP, over 25,000 hours of emergency room and critical care experience. Plus, board certified in critical care for many years. I'm glad to have worked collaboratively with all team members but I feel like many don't realize how much of my critical care RN background has helped me as a NP. Just a RN/NP perspective in the grand scheme of things. What's interesting too is some of the privileges I have to fill out for a NP are for RN duties, like placing a foley, a dobhoff, or even an IV. Although I place Central lines, HD catheters, Swans, intubate and place chest tubes now as a NP a lot of my previous RN duties overlap with the APP.
The MD route at one point in time probably made a lot of sense but unless you want to do surgery or just be at the top of the chain it doesn't anymore. By the time you factor in the debt, malpractice insurance, liability, time, and schedule it no longer makes sense. Sure they earn more but they also don't fully make it into the workforce under their own practice until 5-10yrs later than PA/NP and those routes don't have even close to the same expenses. The PA/NP can still write prescriptions, make care plans, order labs. They both make pretty good money. I don't see many situations where in modern times it makes sense to get the MD and that's why I think you'll continue to see a shortage.
I agree. I'm finishing up my BSN while working in the hospital currently along with my other job and I'm looking to become an NP. I understand the contentions and struggles between MD/DO and NP. I think mid levels are good, but I would never work as an NP on my own. Perhaps I would have the correct amount of training years into my profession, but there is something nice about being able to bounce ideas off of someone else who's qualified and to talk to them as an equal about patient care. Prevents medical inaccuracies occuring. Sadly, we're in a position where no one wants to work throughout their entire 20s to become a primary physician. At that point, a lot of them would then want to go into specialty and make a lot more money. I will say that there is a bubble with NPs who graduate and have no idea what they're doing because they were just trying to prescribe and diagnose without doing the hard work of understanding the pathophysiology. I see it in undergraduate and the workplace all of the time. So, I understand MD/DP frustrations there and it's not really just a lack of training issue. It's that some people will always try to find shortcuts and aren't genuine about being excellent providers, but making money.
At the end, don't forget to mention that scope creep is partially due to task shifting from higher level professionals to lower in order to meet the public health burden. We don't have enough doctors, and so NPs and PAs take on more responsibilities in order to fill in the gaps. It is shaky ground to have expanding scopes of practice without proper comparative educational standards, but there are significant benefits compared to providing no care at all to populations who cannot reach a MD/DO.
First, I want to say I find this video incredibly helpful. I’m a current nursing student who’s struggling with deciding what I want to get into after I get my BSN (between doing NP vs PA).
That being said, I felt that the sudden about-face by the last minute of this video from objective information to “yeah, all these fields are fine, but seriously MDs you should be scared, NPs are coming after your money, patient care is failing, emotions are winning over facts, must remove toxic from the community” was… entertaining to say the least. XD
I mean, I get the slight bias, this is a Med School YT channel after all. Not even saying some of the points aren’t well-reasoned. Just saying the acute shift in tone was not lost on me, and I found it slightly jarring/very interesting.
100% agreed
Thank god I’m not the only one. I was on board with most of his points until it turned weird at the end. Like, it got strangely politically loaded about how NP/PAs who seek greater scope of practice are subject to the “current climate of putting emotions over facts.” That is just conjecture with no data to support it and I expected better from this channel.
Also, the physician lobbys are very powerful. Much more than NP/PAs are. Idk where he got that information
I’m glad I’m not the only one who heard an emotional biased tone with some of what was said either
YES!! Thank you
As someone who applied and was accepted to PA school this year and while I agree with the majority of this video, I would like to add that the average accepted PA student has a 3.6 GPA (and this will include all grades even if you used grade forgiveness). You are not considered commpetitve if you don't have 2000 patient contact hours. On top of that, PA schools also look out for healthcare hours (different from patient conntact), shadowing, volunteering, research, and leadership hours just the same as med school. It took me many years before I felt competitive enough to apply.
I agree! I think the PA program requirements are downplayed in this video for sure.
So what did u do in the meantime ? We’re you a nurse trying to gain experience in the field ?
Do you have any recommendations for the shadowing, volunteering and research hours ? Would they have to be directly connected to becoming a PA ?
Glad this was near the top so people can see. PA school is very competitive. Not as competitive as med school but they’re both hard to get into.
Does it help that I’m in a program to becoming a Cardiovascular Technician and currently doing direct patient care? I’ve never gone to real university but I wanna join the PA program and first get my bachelor’s degree before applying
I would just like to add that many PA schools also look for shadowing & volunteer hours on top of patient care experience. As well as some PA schools are requiring the PACAT now in addition to the gre.
Was going to say the same thing. I'd also say that the average required patient care hours is more around 2000, along with required healthcare hours, volunteer hours, shadowing hours, research (less so than med school), and leadership hours. It took me 2.5 years to feel competitive enough to apply. This is coming from someone who applied and was accepted this cycle.
@@logan804 yess!!! Its a ton you need for pa school.
This channel is pretty useful since I’m going to (hopefully) be a Physician
Don't say hopefully
You will be
@@ericmanso7355 👌👍
Excellent. Later in the vid, you mentioned something like, basically 'fact-focus' versus 'feelings-focused practice. And bringing those circles of study less apart each other. A practice in humanity must be both. No flower has only one petal. Human health is the same way.
As a patient, my experience is that NPs take patient history and physical exam more seriously than MDs. I usually feel that my care from a NP is better than from an MD. I have been more thoroughly treated and more gently treated by the NP. Obviously, I am a great fan of NPs.
I have heard this a lot from patients in the hospital:)
I was premed, switched to the nursing/NP route after working in a hospital and realizing how much more interactions nurses have with their patients, than their physicians.
Lol sure you did
@@theminimalist1549 Meaning...?
@@theminimalist1549 it’s true. This has led me to think; go nursing route if you want more contact with patients or go medical route if you want more contact with other healthcare professionals.
@@theminimalist1549 "lol sure you did" meaning what exactly?
Doubting that the they chose nursing over medicine?
I'm curious as well, but you didn't need ti make such a condescending quip about it.
Chose to become and doctor, and I am so happy I did. No other profession will do. :)
wish I had! biggest mistake I ever made! wanted to be a mommy!
You + PPP could do wonders for this career.
I really wish federal student loans didn’t have interest since it’s from the government. It would make paying back student loans a lot easier
Completely agree. We should be expected to pay our loan back but with not interest.
@@99krispin Yep, 100%. I’m currently decided between med and PA school since med school is so expensive but the interest just increases it. I don’t know how fast I’d be able to pay off the loans+interest if I were to go with primary care 😬
True, but RePAYE makes the interest thing a little less of an issue during residency.
An interesting thing with federal student loans in the US is that PA programs are not yet recognized as a "medical" program, so they don't benefit from a higher cap on federal direct unsubsidized loans. For example, a student in a DO program (or even a Doctor of Naturopathy program) will be able to take out about 40k in unsubsidized loans before they hit the cap and have to begin taking out Grad PLUS loans (which have a higher interest rate). Whereas a PA student can only take out about 20K before having to start taking out Grad PLUS loans, despite the comparable annual tuition costs. Even masters students studying public health or health administration have an increased cap.
@@99krispin That’s so entitled. The government doesn’t owe you interest-free loans. And an interest-free loan isn’t equal for all parties; the government would be losing 2% per year via inflation. $100,000 today is worth about $150,000 in 20 years.
Love this video! One of the most informative and thorough videos out there regarding this topic! And kudos for shouting out the PPP! It's about time we start fighting for physicians rights. :)
Could you do a "So You Want to Be" a Genetic Counselor video? I love watching your videos because they have greatly helped me in my journey in science and medicine and in deciding my career path.
What really needs to be addressed is how poorly conducted some of these collaborative agreements are. There are some NPs who are practicing while the physician who is ‘supervising’ them is actually miles away mindlessly signing off charts so they can collect a extra paycheck. They aren’t actually supervising them at all, just accepting liability and collecting money associated with it. This is why midlevels have successful state hearings regarding FPA. The argument ‘midlevels need more supervision’ never holds up once it's shown how ridiculous some of these collaborative agreements are. Physicians are then painted as greedy money grubbers (which to be fair, in this situation might be true) and FPA is awarded to the midlevels. If FPA is to be stopped, we on the medical side need to clean up poorly managed collaborative supervision. Personally I’m not worried about FPA because patients are starting to recognize the difference in training and many express angst they can’t find a physician in their area; only midlevels. I’m applying FM this year and am excited for the future of it.
Congratulations on starting FM! Please make sure to keep the midlevels out of the way so that patients can receive the best care possible.
It should be illegal. Shame on the NP, but shame on the doctors too.
Should be illegal. Both the np and doctor should be required to be in office at the same time
I understand your point of view, but this like you said this situation is prominent in some practices. That’s is why there are organizations to check situations like these and if you’re not doing your part in reporting it, then you may be part of the problem as well. It’s unfortunate that that is occurring but you’re acting like there is no remedy for it.
There is no point in reporting it when what is happening is legal.
I'm sure a lot of people are wondering what path they should take. as a doctor myself I always give people this advice: *once the opportunity to apply to med school has arrived or is arriving soon, if you are not 100% certain you want to go to med school, don't do it*. Med school is not for everyone and there are many patient-centered professions that don't require what med school and residency does. I'm sure there are many who would say "I wasn't sure about med school but now Im an MD and so happy with my decision." While this is true, it is an extremely risky life commitment to make if things don't pan out and you have 400k in debt and no medical license, or you do but hate your job.
this advice is why I didn't do it. I graduated with a 4.1 GPA, all the shadowing and letters lined up to go. But I kept having doubts about it and couldn't do it. I'm in an accelerated RN program now, occasionally I regret not going to med. but when I see my college friend who is doing MD in the same center I am reminded he will still be in residency when we are 34
@@jakehermo3075 yep I turn 34 in a few months and will still be a resident! Your life will be richly rewarded for following your gut.
@@OllertonMD everything works out in the end. I wanted to do anesthesiology if I did med so worse case I go CRNA later anyway. what specialty are you in if you don't mind me asking?
@@jakehermo3075 psychiatry, in my final year of residency :) ! its nice going from being treated like garbage as a med student to being treated with decency now haha
@Simple Psychiatry MD I've always wanted to be an MD. In fact I started out pre-med, but changed later on due to certain situations in life preventing me from going to school entirely. I'm now in respiratory therapy, with the goal of eventually going for PA. I'm 32, but with other factors besides time at play, medical school and residency would probably overall have a negative impact on me. It's unfortunate because MD is what I've wanted as far back as I can remember, but I can say I've found that I love work life balance I have as a respiratory therapist, and that can very much translate over into the work life balance a PA can have. Definitely a positive for sure, but deep down I'm going to always want that MD.
I watched this knowing 100% that I want to be a CRNA 😂 very informative tho! Good luck to those considering any of these amazing professions.
Update?
I am a physician. Has bern one for 26 years after Med School. I don't regreted it but aftercso msny regulations and disrespect toward physicians, I'm advising my daughter not go to Med School and to do the NP route. I see my NPs that work in my setting more happier and less stressful that us with EHRs, licenses, MOC exams, CMEs, and patients unreasonable expectations.
In Ontario NP's can prescribed (limited) medication. Even my teacher in nursing school got an extended class license (she was a RN) to work as an NP and work North of Dawson City, Yukon where there were no MD's.
I believe even now a RN/ RPN can give OTC medication (depending on your institute policy) without a prescription as long as they possess the knowledge, skill, and judgment to do so.
Yes in US NP can prescribe medications as well as controlled substance. RNs cannot unless they have NP and are certified
With experience, on the job responsibilities should gradually increase with PA/NP track, varying from person to person
That part about varying from person to person is what makes years of experience not useful... If something like that were to be implemented, there would need to be exams along the way to ensure base level of competency.
Wish that DO was on the title pic, but glad to see it was mentioned in the vid. We make up 20% of med students now.
Thanks for mentioning that as I’m planning to apply to DO schools in 2023
I’d like to see more on people looking for a reliable Bridge Program from PA to MD/DO. While not everyone will be interested in doing so, I think outlining a better more clear avenue could aid PAs who are in fact ready to take that next step in medical training and knowledge. Even more so they will already have on the job knowledge and experience that would be very valuable to carry upwards.
That bridge program would be medical school.
@@theminimalist1549 No shit. That’s what they are asking.
@@MJL144 I am a PA. If a person wants to obtain an MD, that person goes to medical school. There is no short cut just because a person is already a PA.
@Elizabeth Brandon but a bridge program would be nice, right? Doesn't mean you have any less training overall, or have it arguably any easier, it just builds and expands on PA. I don't think it would be entirely impossible to bridge that gap. Say a 2-3 year program for current PA with X amount of experience, then residency on top of that. Obviously, this is all hypothetical, plus coming from someone who has yet to attend PA school so I don't know what it is like.
I myself am in respiratory therapy, with the goal of eventually going to PA school. While MD would be nice I prefer the work life balance that I have now, but want to do more. Hence why I'm going PA. Even if a bridge program from PA to MD did exist, I probably wouldn't make use of it as I'm fine working my three to four 12 hour shifts a week.
Lecom has a program
Dr. Jubbal, thank you for being the eternal giver of truth. Your takes are refreshing when the AMA is slow to react to midlevel creep.
It's okay man
As a licensed psychotherapist who just got licensed as an RN yesterday, I went to nursing school specifically to be a psych NP. I think psych is certainly different (comparatively) than most of medsurge focus of the video, but for anyone to argue that physicians are not more qualified and vastly more knowledgeable (and should be compensated as such, esp given med school expense), has lost the plot. I already have 12.5 yrs of school (w/ 5 more to go), will have two master's and a doctorate, and still understand this. Will not being called "doctor" after all this suck? Am I a complete idiot for not going to med school given my ridiculous amount of time already in college? Both of these answers are a "yes" if I'm honest.
Had I gotten my doc in psych, I would have been called a doctor because it is representative of having a terminal degree and being at the top of my profession. I started in a program (7 more years for clinical psych) but changed my mind because there was very little else that I could do professionally and the time/money did not seem to bring a significant advantage. Back to vernacular; I've worked with many of these "doctors" and they always present themselves as "Dr. such and such, clinical psychologist." The one DNP that I've ever came across did the same. The problem is, most people have no clue what a DNP is, so...that needs explanation in my opinion.
Dunno. I understand both arguments. And, I'm a "facts over feelings" kinda guy. In academia, we have created a mess with chasing titles because titles = prestige, where prestige = competence and wealth. This is another rant altogether.
I honestly love how you put this!
@@suckmy401k thank you!
as a DO I would NEVER become anything other than a doctor. time and money spent were well worth it, dont let anyone (esp someone who did not got to medical school try and convince you otherwise)
ive always been treated better, as a patient, by NP's than MDs
This is a great video, well researched too. It's nice to learn about details about each path.
Wow! Thank you for such a thoughtful and comprehensive overview. Such a helpful video!!!!!!!
I am 43 and decided that being an cert. Opthalmic Medical Technician is just not my vibe. So, here I am plodding along to get my BSN ,minor in psych and forensics. Then onto my NP. I'll probably be 50 by the time I'm done 😂 but done I will be ❤
Not sure I totally agree. It is the responsibility of any provider in primary care to admit what is beyond the scope of what they can treat. Just because an NP may be less experienced doesn’t mean they shouldn’t be able to practice independently. They can practice independently and still refer out patients that are beyond their capabilities to either a primary care physician or a specialist. Just as a primary care physician is expected to refer out certain conditions to specialists.
Thank you for this! I am leaning more towards the NP route now and was previously deeply confused!! Still undecided if I want to get my BSN before my MSN.
The problem is that most of the time the patient does not have a choice. Nowadays, when you make a doctor's appointment, you are most likely scheduled with a PA or NP. I don't have a problem with either as I have worked along side them for many years. I just think that if you are told that you must see an NP or PA because of scheduling conflicts and you can't see an MD, then you should not pay the same price. Insurance companies, Big Pharma and medical facilities love PA's and NP's because they are able to charge the same for services and they keep the number of prescriptions written high which results in huge profits. There are about 179 medical schools in this country and 400 nurse practitioner programs. Something is definitely wrong with our healthcare model when the number of graduate physicians are far less than graduate PA's and NP's. There needs to be more of an effort to decrease the costs of medical school and incentivize people who possess the intellect to pursue medicine. An NP or PA were never meant to replace MD's but that seems to be where we are going because of the shortage of MD's we're currently experiencing.
i agrée as a high school senior i want to be an anesthesiologist but i keep seeing the stats of mes school and residency and i think about how i will barely have time to live my life and start a family and it’s all so worrisome. imagine if after all that you don’t make it into med school and even if u do u might not make it into residency
Yay you highlighted my comment about PA scope creep in a previous video and then actually made the video🙂
Beautifully done🔥
Pre-Med student here and while I know pre-meds don’t know much outside of Mitosis, I have been an Advanced EMT since high school, and I have worked in primary care clinics with many MD, DO physicians and also PA and NP’s. I have chosen Pre-Med and MD because I know I want to go into trauma surgery and at the end of the day PA, and NP’s will never be surgeons. However if I wanted to work I. Primary care clinics I would 100% choose PA and NP because less training, less debt, and much less effort in training. The MD’s I worked with always got patients passed from the PA’s because of the increased knowledge when we had something that wasn’t textbook. It all comes down to what will make you happy? I know I love healthcare and I could work in surgery as a PA but I would never be the surgeon and that isn’t enough for me!
That is what I am trying to decide too… I would love to perform plastic surgery but I am already 29 and I already have a bachelor’s degree and I was thinking to apply to be a MD but it would take me many years and I would like to get married and have a family by 35 hahaha 🤣
Never say never.
Knowing the scope of practice, is also knowing what isn't. A Primary Care Doc will refer to specialists once a patient's concerns might be out of their scope of practice. NP's do the same. Practicing independently doesn't mean that an NP can take care of every condition, it means they are independent professionals.
There are current states that allow NP's to practice independently. If the concern is patient safety, then it seems a simple matter of looking into patient outcome data from those states, compared to states where NP's are supervised.
A proficient primary care doc should be able to manage and work up conditions to an extent. i'm willing to bet that a majority of physicians would be able to manage more conditions without sending the patient to a specialist which costs the patient more time and money but someone with vastly less training would have a lower threshold for referring to specialists.
@@Benboy887 Why would a general practitioner"manage and work up" conditions out of their scope of practice?
This sounds like your own fiction and not reality.
@@cathiehealey4608 They would manage and work up conditions to know what they are consulting for in the first place. Additionally, if it turns out to be a condition that is easily treatable and the person doesn't have a complex medical history then referring isn't necessary. It isn't own fiction, it's what was and SHOULD be the case but PCPs have become more referral generators with midlevels being the worst perpetrators. Many of the specialists I have worked with have said "I'm happy to see this patient, but they could be easily managed by their PCP."
@@Benboy887 That's fine once they're seen by a specialist. Just because they're seen by a specialist, it doesn't mean they have to have the condition managed by the specialist after they diagnose it. f it's an uncomplicated, chronic condition, then a PCP (no matter the initials after their name) can manage it. That doesn't mean they shouldn't have been seen by a specialist. If the specialist sees it hundreds of times a year and a PCP see's it once a year, the specialist should be diagnosing it. It's out of the PCP's scope of practice.
Just seems like you're working pretty hard to create a situation that may or may not happen.
Everyone has a scope of practice, and everyone is expected to practice within theirs.
@@cathiehealey4608 I get what you mean, that is certainly the case when someone is referred for something enigmatic.
However, I mean I personaly knew a NP that has been a PCP for years who referred an elderly patient to a urologist for a single PSA value slightly above threshold and the urologist was like, "I'm not sure why you're even here, we trend these values." Never saw a physician refer for a PSA like that while I worked at that clinic for over a year I worked there. All I'm saying is, an MD/DO will be better able to manage those conditions than a midlevel and would likely be able to determine is something is worth referring or not. It isn't to say that the MD doesn't over refer, but it is much less likely. And many physicians I've worked with in my area during clerkships have complained about bad referrals from midlevels. It's a meaningful phenomena.
Scope of practice is broader for a MD/DO in the primary care fields. It should be much narrower for NPs/PAs as their training path is not comparable and so their scope of practice is narrower.
THIS IS LITERALLY WHAT I NEEDED!!!
As an urgent care RN I work with all the above - MDs, NPs, and PAs. I can definitely see a difference in their training especially with emergent cases. However, there are incredible providers from each of the respective backgrounds (and also terrible from each as well).
One thing with NPs, most of them have been a registered nurse for 5,10,15 years etc. So they come into NP already with a ton of knowledge, hours, experience.
Excellent breakdown. Thanks for putting this together!
As someone who has a bachelor's in biology, a BSN, a GPA of 3.84 and experience both as a practicing nurse, and in an epigenetic research lab focussing on fundamental nutrient pathways and reproduction; the way you degrade NPs and PAs in this video is astounding.
I have made the decision to pursue midwifery practice as a nurse practitioner program (DNP), not because I was afraid to work hard (or have poor GPA) as the video implies, but because the model of care better aligns with my values.
I fully intend to open a private practice as an NP. The decision is not because of a capped pay, or because I have more time on my hands to lobby for it. There is a need in my community. If filling the need means some pompous guy on TH-cam labels me a scope creeper, so be it. 😂
The goal of competency and high level functioning in a field should never be restricted to only one path of learning. Yes, physicians may come out of medical school with more knowledge than a graduating NP or PA. However, if you believe that means that they perpetually maintain superior knowledge than everyone in other fields, you are delusional.
If you want it, go for it! It's cool you did both biology and nursing!
hey all, I just took my MCAT yesterday. future MD/DO. i’m nervous about getting my score back. but i really want this career. i really do.
You got this, don’t give up
How did it go ?
@@anglecke6543 terrible :) i registered for a retake this morning
@@hannahbanana2311 you got this!
It’s been 2 years do we have an update :))
ER nurse to ER NP. Job is chill, alot less stress then being an ER or ICU nurse and I just deal with the "boring" stuff.
As a RN I will not invest the money or the time in becoming an NP. It's not worth it. It will not be much of a salary increase especially when I travel. Many of my travel nurses make 150-170k (low end) a year doing fulltime traveling just as a nurse and get to explore new areas.
My aunt became an NP. The only reason she made that leap is her employer covered her education expenses 100%, otherwise she wouldn't have just for the extra 10-15 grand a year in her area.
@@bluejedi723 I bet that came with work commitment lol Maybe 5 years. Most hospitals wouldn't even pay for BSN without work commitment. 10-15k? That's so low for carrying so many risks and responsibilities as a provider.
Why not nurse anesthesist?
MS1 here .... Yesterday we had a call with other healthcare team members talking about this!
Really?? What was so important to discuss?? You already made your choice right? Wasn’t the point of this video to “educate” others on each career path??
These are so helpful thanks for making them! If I had seen this sooner I probably wouldve chosen a PA path admittedly lol I didnt meet a PA till I was a junior in college, deep in my Pre-Med track
Now, I'm a 4th year medical student (4 out of 7yrs in Havana, Cuba) and feel fulfillment with my choice and values but I sometimes wonder if I had been introduced to more critical career thinking and taught about prioritizing a healthier work-life balance if I would've still gone to medical school. Admittedly I do think the biggest perk is the opportunities and income attached to an MD career (and people still are still much more preferencial to the "Doctor" title when seeking care which to me is an "accessibility perk" to the populations I wanna serve) - but then you can still do alot of good work and be a good person without the traumatic drama of glory? It's really up to the individual at the end of the day.
Hi, I’m thinking about pursuing medical school but the most debilitating factor is the cost. How did you manage to afford medical school?
@@qwq2170 im on scholarship specifically for americans who want to study medicine in Cuba. Without this I would absolutely be in crippling debt in the US because medical school scholarships are basically nonexistent and the total cost (paperwork fees, scrubs, textbooks, etc) continue to rise. I recommend really studying between PA, NP, DO and MD career choices and if you really want MD try to secure as much family/community support, Grants and outside scholarships (from foundations or wtv). If you're interested in my med school lemme know. Otherwise hope that helped and best of luck!
@@ayrang25 damn that’s unfortunate how scholarships for US medical schools are lacking. But nonetheless I really appreciate your answer and I’ll reach out if I have any more questions. Thank you :)
I am a FNP. I did 5 years to become a RN. Before applying to NP school you need one year of med-surg and one year of critical care. Then NP program is 3.5 yrs at Pace University. Then, pass boards. NP must do clinicals at the same time of didactic work. Patients prefer NP because we take more time doing our physical exams and since we trained to be excellent communicators, patient trust our care.
Thank you for standing up for common sense. I hope you make more videos on scope of practice in the future.
I hear praise from nurses to be a NP because you have to actually be a nurse first and go into the tranches to serve people. Most doctors they have worked on the er tend to be clueless and often have the head nurse take over. I’d say patient exposure experience is superior to diddling with your pen with 10 textbooks experience
Until something is done both about the debt burden of medical school AND the fact that around 8% of medical student will not match into a residency because of the residency shortage medical school seems like a serious gamble even for those who are interested. Also, it’s crazy to me that the NP’s had a higher average salary than the PA’s.
Good point about medical school debt. That's one of the many reasons why I declined my medical school acceptance. As for the NP and PA salaries, they are similar. They aren't that far off. If they are far off, it's usually because of a certain specialty route (which PAs can also choose and make more money).
Can’t wait to become a NP 😊
see being an np or pa sounds amazing but i reallly like surgery so i’m still stumped
EXACT same as me !!!
PA Programs are Master's Program with more and more doctorate programs creeping up. When I was a practicing PA I always felt most comfortable with an M.D. near by. ❤
I wanted to get into medicine to be the expert in what I am passionate about. That requires the most education and training available, which would be the physician route. PA's and NP's simply do not receive the amount of education and training to be considered equivalent, no matter how they will try and spin that they know "just as much if not more" than physicians.
This wouldn't fly in any other career field so I'm not sure why healthcare is so loose with their training requirements. A flight attendant wouldn't be allowed to fly the plane if they shadowed a pilot for 500 hours so why are NP's allowed to practice unsupervised after minimal clinical training in NP school?
The reason why it's occurring in the medical field is because of physician shortage (which is mainly due to how unattractive the physician route is becoming). PAs and NPs are ranked as some of the best jobs in the US according to USnews (#1 and #3 respectively), and they still make a lot of money (PAs usually have a higher net worth than doctors until the mid 50s) and don't have to sacrifice their 20s and 30s to residency and med school.
So unsurprisingly, more and more people are either not going into healthcare or becoming midlevels rather than doctors, which is why hospitals are eager to hire them.
As a bit of a sidenote, I do think the analogy of flight attendant to pilot is a bit unfair here (at least for PAs).
@@adr77510 You are 100% incorrect. Med school application numbers and stats are higher ever year. US News is largely a flawed reporting outlet, with subjective views based on their main audience. You are also incorrect about the net worth of physicians, most by their early 40s are pretty secure, granted they don't spend their attending salaries like idiots.
Lastly it is very inappropriate for anyone to make the assumption we give up our 20s/30s. TMed students are some of the most talented people; who know how to balance their lives. I've had many friends that got married and had kids in med school, explored interests and hobbies outside of medicine to the fullest extent, traveled the world, etc.
Becoming a midlevel is hella easy, at least for any person who can get into med school. Hospitals are hiring them because they're cheap labor and the ones running hospitals are MBAs.
The analogy is great. I have multiple PA friends that know enough to do bread/butter but don't have any depth of understanding to the why. PAs have a role in medicine and when they work collaboratively with physicians, it is very beneficial to patients.
@@studyingandstuff435 med school applicants are rising every year, but there are still far fewer applicants for med school rather than for law school or business school. I don’t know where you heard US news wasn’t a good source, because it’s overall considered very reliable. The net worth part is true too, and is explained pretty well in Dr. Juballs physician vs engineer video, in which he shows that engineers (who make around 80K) have higher net worth’s than physicians until their mid 40s. PAs and NPs both start off making 6 figures so that number would take them into their mid 50s. That’s not because physicians aren’t financially secure by that time (they are already well off by 40), but rather because midlevels are even better off.
And I do stand by the fact that you have to sacrifice your 20s to healthcare. Med students have told me that they rarely have free time and that they are either busy studying or researching. Residents have it arguably worse because they can stay in the hospital up to 26 hours straight. Compared to med school, PA school and NP school are both considerably easy, which is another reason people choose that path. PA school though is still no walk in the park and isn’t easy to get into either. I do agree that hospitals hire them because they are cheaper to hire, but they wouldn’t be given the opportunity to if their were a surplus of doctors
And the analogy, at least for PAs (I see the logic for NPs), is incorrect. Flight attendant to pilot is like nurse to doctor. PAs are given a medical education rather than a nursing education and are taught to do the bread and butter (nurses aren’t). NPs are given a nursing education so the logic applies for them.
@@adr77510 a lot of what you've been saying is wrong but lets just focus on how wrong your net worth numbers are LOL. if you're comparing a family med doc to the midlevels. Fam med takes 11 yrs compared to PA/NPs 6-7 years. Average fam doc salary as stated in this vid is 240k, avg PA/NP salary is 100-110k. So assuming starting from age 18, fam med doc starts getting paid age 29. PA/NPs start at 24-25. The PAs/NPs have 4-5 years of income more than the fam doc. Lets assume the maximum amount of 550k and ignore taxes. Now if the fam doc makes 130k more per yr than the PA/NPs, how long does it take them to erase the difference...550/130= 4 yrs 3 months. Age 33. After age 33, the fam doc more than doubles the PA/NPs money to the bank. By age 45 (since you referred to mid 40s), the fam doc has made 1.5m more than the midlevels. By age 55 (since you referred to mid (50s), the fam doc has made 2.8m more than the mid levels. Substract their ~200k school debt from their millions. Tell me again how physicians would take until mid 50s to catch up Lol. Also half of doctors are specialists, avg salary as stated in this vid 340k. Residency slightly longer for the less lucrative ones and much longer for the more lucrative ones. When Spine surgeons rake 800k / yr, how fast do you think they catch up?
@@adr77510 Looks like you're getting attacked by a lot of hyper neurotic Premeds. Your points were well articulated and non argumentative. Just thought I'd throw that out.
In my opinion if APPs want independent practice they should have to complete a full length residency equal to the standards of physicians and then everyone takes the same specific specialty's board exam
That sounds an awful lot like medical school
@@shlang23 I don't think so, they would still go through their respective post bachelor education programs (PA, NP, CRNA etc) but to practice independently they would have to complete a residency of equal standards and then prove their knowledge competency via the specialty's board exam. I wouldn't have any issue with independent practice after that. I would even support equal pay
@@mattgehm7827 No if you want full practice authority you go to medical school. Midlevel schooling not even a fraction as rigorous/comprehensive as medical school.
Medical school + Residency= Physician.
There's no shortcut when peoples lives are at stake
@@cubsfan708 well really med school= physician if you want to be like that. And I'm not egotistical enough to say only physicians can have independent practice. I think in reality it's the post medical training education that makes someone a provider. If APPs were to complete a residency of equal standards and then take the same specialty board exam as a physician I would have no problem with it
@@mattgehm7827 I apologize I read my post and came off as a dick. I dont think its about ego but about having the most capable providers. I think it would make more sense for the AMA to lobby the government to increase funding for more residency seats. I also think the government should provide more loan forgiveness programs and incentives to Doctors that decide to work in rural/medically underserved communities. This would be much better than increasing scope of practice for midlevels.
Certified wound care nurse here. Almost done with my Master's and then will go for NP. I've seen this topic debated for so long. I work with so many NPs, PAs, and Physicians in a large academic medical center. Honestly, patients mostly don't care who's treating them as long as they're being treated with the best care. I don't feel that these professions are "better" than the others. As this video mentions, it's just what best fits the needed role and your preferences. I recommend to Physicians the best evidence wound care and they respect me and listen because they know I am the expert on that topic, however I 100% respect and recognize their immense knowledge and the things they do that I can't. That yields the best outcomes. Yes, there should also be room for some change. Maybe there are more things that NPs and PAs can do on their own and they are lobbying for that, but that also ultimately helps Physicians so they can focus on more complex cases. I feel like the mindset should be to be the best in whatever your role or profession is. The best NP/PA at their peak is going to do more for patients than a Physician who is not practicing at their best, and vice-versa. In the overall view of healthcare, we are all a team and we function best that way!
NPs can work on there on in most states, and others need an agreement with MDs. PAs can't do this.
From this video I realized it is really hard to be NP here in Canada. You must have 3 years RN experience (5000 hours to be exact) and 3.5 GPA Minimum for most institutions. So it takes almost 9-10 years full time.
What ... Emotions over logic ? Yeah a lot of that going around today .
On all sides...
Unless it's for something simple, I always see a doctor over an NP (never seen a PA before, never had the opportunity). NP's don't receive the same training on disease-related illnesses that doctors do---this means that an NP is going to refer you to a specialist, where as in many cases, a doctor can diagnose the disease with things like bloodwork, and can write a prescription on the spot
I’m going to NP, since I’m finishing my BSN at 41 yrs. however, I understand that I won’t be neither qualified nor trained as a physician, and yes, I don’t mind working under a supervision of a physician.
Certainly a Cardiovascular Tech, definitely looking into to PA because of this video
Can you tell me more about this career? The pay and pros and cons and the schooling process
@@ahlam2795 for cardiovascular tech?
Just like you. Here I am, a Cardiac Sonographer/Physiologist looking into the PA in Cardiology role.
It doesn't make any sense if "Midlevels" are lobbying for greater scope! That is why we have the physicians out there!
Current PA student here:
1. My argument for greater scope of practice is solely so that my future supervising MD/DO has the legal ability to entrust me with greater and greater responsibilities. If I've trained under them for years and they feel I am qualified to handle a certain procedure, I believe they should have the legal standing to do so.
2. I feel it is ABSOLUTELY dangerous for NPs, especially those doing the direct path, to be allowed to open independent practice. Us mid-levels just straight up do not have sufficient training to do so. That's not the point of the job. You decide to become a mid-level because you want to care for patients under a supervising physician. If your dream or goal is to be autonomous, then you go to med school. It's simple as that.
That’s one of several reasons I want to go to med school
This. Unfortunately whenever the discussion of "scope creep" is had without a PA, it fails to recognize that the vast majority of PAs understand that our role is to practice medicine alongside a supervising physician. PAs generally understand that their training does not qualify them to practice entirely independently in any specialty. Most of us find NP lobbying for independent practice incredibly dangerous.
Also the AAPA is not great at lobbying. Our numbers are so small compared to the nursing lobbies and we don't have time in PA school to take a class on lobbying (an actual course in a many nursing/NP programs) since we're busy studying medicine.
That being said, there's potentially great benefit to reducing the administrative burdens involved in hiring a PA and maintaining strict requirements between a PA and their SP. It's unfortunate that while NPs lobby for full practice authority and are gaining it in some states, NPs are preferentially hired simply because they're easier to hire. I hope people stop lumping PAs with NPs in this discussion. We'd have a much more productive conversation if that was the case.
There is sanity in the world. TY
The issue with FPA for midlevels is that even if you get greater scope of practice just for your situation, it will be exploited by companies and hospitals to save a quick buck at the expense of patient safety. We're seeing it now with various hospital groups firing physicians and hiring many more midlevels.
It just isn't worth it.
It’s idealistic to say that the supervising physician will determine how much responsibility they trust you with. In my experience, admin is setting up staffing so there’s not enough doctors and then mid levels are told they need to pick up the slack which means going beyond their scope.
Pretty accurate, I mean we’d be kidding ourselves to say that there isn’t a tad bit of bias (lists out undergrad years for med school [in a nice linear fashion] but only graduate years for other routes 🤔) but he is absolutely right in respect to the rigor. I honestly respect anyone who has not only made it through residency but also a fellowship. On a separate note, when talking mid level creep, there is a world of difference between an NP program and a CRNA program, both in terms of competitiveness and rigor. In addition a CRNA is trained to do one SPECIFIC job, not as a generalist to fill any number of roles. No disrespect to my NP colleagues but they can’t really be lumped together.
All NP's are trained for one specialty. There are Psych NP's, Family NP's are trained for primary care, Nurse Midwives, are NP's trained to care for pregnant women and newborns, and CRNA's are nurse anesthesists.
As compared with the PA Model where they're trained as generalists.
I noticed that too! He left out the undergrad for PA and Nursing but then listed it for medical school as if to say that medical students have 12 years of experience while a PA has like 4. That’s not true, a PA has four years of undergrad and four for for PA school
Look before you jump. Many of the better PA schools only ACCEPT between 4% to 8% of the people who APPLY to the school in a given year. You may have to apply to a large number of schools, perhaps some not-so-good ones, to get into any of them.
Most docs don't give enough cred to the FM docs. Heck, speciality med I think is also trying to limit the scope of FM docs - trying to make them irrelevant.
Great video, just a bit biased at the end especially with the link lol
i am literally in tenth grade and i’m just stressing over if i want to be an NP or a MD, i love the idea of clinical hours and all of that stuff but the burden of medical school seems so overwhelming
@@yugnok okay, wtf? healthcare is my passion, we need doctors and nurses and PAs in this world. just because YOU don’t like it doesn’t mean no one else should. let people do what they want to do. i’m willing to go on the path that i need to take to work in healthcare.
@@yugnok you know 100 physicians, but not NPs or PAs right? Pretty sure NP/PAs are more likely to love their job and do it over again if they have to.
Omg me to I am in my 10 grade i dont know if I should choose bw pa or np or md . But trust me u will know after 12 anyways so just keep studying science well . And don't listen to PPL who are telling u don't go to healthcare , do what u can do . And u will see u will do it . Hope u ganna become what u wanna be in life bye have fun.
omg twins! i am also in tenth grade and also losing my mind over this big decision. have you decided anything yet?
Go to a community college for your first two years to prevent taking out loans. Pick a major that you know you'll get A's in and take the requisite pre-med courses as electives and work hard in those classes.
On the job training is highly variable and there needs to be standardized bodies to regulate this for the patient.
Just like it's mentioned in the video briefly, for NPs, we have to choose the specialty before we apply for the program. I'm a psych NP who finished 3 years of psych training (1 year of clinical rotation only in psych- some programs require more than a year). If I ever change my mind and want to practice as a family NP, I have to go back to school for family np program and take a different Board exam. While my husband chose to be a physician, I chose to be a nurse practitioner, and I have no regrets! I believe everyone's path is different :)
You won’t have to complete a residency to change specialties. One year of working under a different specialty for 40 hrs a week is nothing compared to working 60-80 hrs a week for 3-7 years
@@yallamafez2428 I was simply explaining how the NP program works since not many people know about NP programs. Did I ever mention that NP programs are equivalent to MD/DO residency programs?
I feel like you failed to highlight the patient care level of each practice. Typically a NP has worked as a nurse for many years and has the most patient care experience. A MD usually graduates with nothing other then their residency and has absolutely so empathy or regard for patient care.
NP and AP is not allowed in Korea. Either nurse or doctor
Cool.
Ideal
As it should be. PA and NP are just nurses, who think they are doctors. It is really dangerous precedens and really making all that study and work that doctors obtain as useless if you can just do a course and you will become kindadoctor.
This video really seems to try to talk people out of going to medical school. I know in the Netherlands (where I live) getting into medical school is really hard (it took me a total of four tries, spread over 2 years, as an above average VWO student). However once your in, you get three years of intense (but extremely interesting) theory (I am in my second year) and afterwards you get three 'clinical years'. After that you also need to specialize, but most of these already pay and they pay relatively well (1200-5000 euros per month).
So I think in the Netherlands once you get in, are motivated and understand it's hard work a lot of the problems pointed out here aren't that bad (only six years of medical school and three of them are purely theoretical, costs are relatively low and if you want to switch your specialty it should be possible). The only thing I know is it's incredibly difficult to get into 'specialist tracks' to for instance become a surgeon or a pediatrician. Meaning that if you are average in medical school you will probably become a general practitioner or a psychiatrist. But I'll see when I get there
Possible video on ways to lower debt in med school/residency? i.e. debt forgiveness programs, working while in school?
I know a NP that claims they know more than MD and is better than PA which baffles me. Good to see in comments that other PA or NP dont think this way.
The biggest hurdle for me to get over is how the 20,000 of residency is heralded as the qualifying distinction (which I can understand), but the years of clinical practice that a nurse has are completely disregarded. Before someone criticizes my point, yes I understand there's a difference between residency and on-the-job practice. I also understand that there are different standards.
The clinical practice of nurses is different than the work of residents. They aren't building differential diagnoses, studying pathology and treatment, and as you said, have different standards. They are totally different jobs and the responsibilities of nursing while good skills to have, but do not necessarily build the skills for medical practice.
@@Benboy887 I agree, totally different worlds. That nursing is nursing, a totally different career which has always been nursing with different purposes. It never included the end goal of prescribing, knowing pharmacokinetics, pharmacodynamics, side-effects, biochemical paths of medications and treatment, the why a medication with its pharmacological effect would work on this or that condition because of the physiological pathway involved in its mechanism of action over the body... it is not shading nursing work, it is just that even lots of experience as a nurse does not equal the nature of the training and experience of a physician because they were both trained in very different terms and for different purposes. I would say PA is more oriented as a second hand for clinical practice for a physician since their training is even shorter and is more focused on medical sciences.
When I was in the Navy we had Independent duty Corpsman. As the name implies they work very much independently from a Dr. I was on a submarine so they were very very independent. They were also very very highly training and capable (many times I preferred seeing the corpsman over a DR. They could every do certain types of surgery. But they also, knew when the medical issue was out of their scope and had no problem arrange for the appropriate level of care. The ironic thing is when they get out all that training is for naught. They basically start over. Although I have hear there are efforts to change some of that.
I see many people mention the medical model vs. the nursing model but never explain the difference. CRNPs follow the nursing model yet can practice independently vs. PAs following the medical model and some not able to practice independently. Can someone offer some clarity here?
This is the video I’ve been looking for!!!
I was recently checking out med schools (hoping to start in 3 years) I found some programs that had 3 year programs! And they have some kind of special residency(3y med school only for Fam, Int or peds) or can pick from a list of specialties that school. Could you do a video about these types of programs please?
For anyone wondering there are only about 15 I think? And they basically just condense the 4 years by skipping summer break. They also seem like they are more specific to the specialty you want to go into.
I’m interested in primary care and I’d love to see a 3 yr med program as an option at more DO schools. For a variety of reasons, I’m only applying to DO schools
These schools do cut out the first year summer and the 4th year that is used to do residency interviews considering that you are not competing with anyone and you already know where you are going and virtually have already been accepted. The concept of a 3 yr program is gaining steam due to students complaining about cost and the value of the 4th year.
Went to a 3 year med school myself and am currently an Emergency Medicine resident. Don't regret the 3 year option at all.
It’s becoming more common to skip 4th year to be locked into a residency
@@sara215 Where is that happening? I've never heard of this as a US MD student.
This video was so helpful! Thank you!!