Time and time again I find the hardest part of helping a student apply to medical school is having the student decide if medical school is right for them. Applicants that aren’t sure, will inevitably show that undecidedness in their applications or during the interview process. This blog will talk about the different medical career tracks, and some tips that you can use to help you figure out if you want to be a physician before you apply.
There are many pieces to the healthcare team. Let’s first talk about roles and career options, and then we’ll look at ways to decipher if becoming a physician is right for you.
At the very top of the medical team’s hierarchy are the physicians. I call it a hierarchy, not because physicians are more important than the other members of the team, but because ultimately they are the ones responsible to coordinate decisions for a patient’s healthcare, and then handle the repercussions of those choices. Other members of the team include mid-level providers, such as nurse practitioners (NPs) and physician assistants (PAs), who work in a similar capacity to a physician, though with a smaller scope of practice in most cases. Collectively, physicians, PAs, and NPs, are called providers. Working under the direction of a provider are the nurses. Working under the direction of nurses are CNAs. It takes the whole team to heal a patient.
Physicians are doctoral level providers that lead the healthcare team in the healing of patients. Their training requires a bachelor’s degree as a pre-requisite, four years of graduate (medical) school, then residency training in a field of medicine. They also require an entrance exam, the MCAT. Physicians have one of the longest training programs of any career track. Students who want to a be a physician, MD or DO, should desire to be the team leader. Other roles a physician provides include being a teacher, healer, researcher, and life-long learner. Medical school is quite expensive, averaging ~200k for graduate school alone. Don’t be too daunted by this, though. In future blogs, I will talk about the repayment plans people can qualify for as well as scholarship opportunities. Physicians make larger salaries than other roles in the healthcare team, with a very large range depending on the field of medicine they are entering. According to Medscape’s evaluation, as cited at the end of the article, physicians average 189-421k/year.
Nurse practitioners are master’s level providers, that typically began as a nurse before entering this graduate program. Some programs require a nursing degree to attend, and some have any bachelor’s as pre-requisite. There is often a GRE as a pre-requite exam. NPs have the ability, in some states, to practice independently. That means that they require no oversight from a physician. A nurse practitioner chooses a field of medicine, such as family practice or psychiatry, and then typically remains in the field that they were trained in. To switch fields of medicine requires more training. Nurse practitioners make, according to Forbes, a salary of ~97k/year. More information about nurse practitioners: http://nurse.org/resources/nurse-practitioner/
Physician assistants are masters level providers who work beneath the supervision of a physician. This role can vary greatly in terms of independence in day to day tasks depending on the field of medicine and the physician that they function under. There is a lot of flexibility in this role as you are trained generally, meaning for many fields of medicine, and are not locked into one. For example, a physician assistant can work in surgery and then decide to switch to emergency medicine. They always function under a physician in some capacity, though. The master’s degree is two years, with a prerequisite of at least two years of undergraduate studies and typically a bachelor’s degree. There is often a GRE as a pre-requisite exam. PAs typically make, according to Forbes, a salary of ~94k/year. More information about physician assistants: https://www.aapa.org/
Nurses are associate level or bachelor level trained professionals. They function under the provider. They are the ones administering medications and evaluating patients throughout the course of the patient’s stay, reporting back changes and concerns to the provider overseeing the care of the patient. Nurses are broadly trained and can switch career fields with ease. Nursing careers can range from the emergency room to family practice offices. The average salary for a nurse, according to US News, is 66k/year. More information about nursing careers: http://www.nurse.com/
Okay, that’s great. So how do you decide?
Ultimately, you will ask yourself, do I like the responsibility and ability to combine all of the available information and then make the decisions about a patient’s care? If you do, then you need to be a provider. Choosing between mid-level degrees (PAs and NPs) and becoming a physician can be a bit tricky and multifactorial. You should take into account time commitments, financial considerations, career goals, desired fields of medicine, and the role you see yourself in.
Time & Money: If you want a shorter path, mid-level training is typically 2 years compared to the minimum of 7 years needed to train a physician. Mid-levels pay less tuition to attend school, though they make less in their career options.
Field of Medicine: In certain fields of medicine, such as family medicine, being an NP may be quite similar to being a physician. If you want to be a cardiothoracic surgeon, you need to opt for medical school. If you like participating in surgeries though without having the ultimate responsibility, surgical PAs work alongside the surgeons to help them operate. Fields of medicine can greatly change your graduate school choices. Explore what fields of medicine intrigue you and how the career options associated with each of them.
SHADOW: If you haven’t begun shadowing in healthcare, you need to. Not only is experience and shadowing a part of the application and interview grading system, it helps you to work with physicians and decide if their job feels right to you. Ask yourself after shadowing, is this a good fit for me? Do I like this field of medicine? If not, try shadowing in a few different fields of medicine. There is a big difference between surgery and family medicine for what a doctor does during the day. You can also try shadowing a PA or NP and see how their role differs from the physician’s role.
TALK: If you are feeling a little undecided, talk to an advisor about it. You can talk to your pre-med advisor, sign up for an advisor here, or simply email me if you just want to talk about this choice. It won’t take away from your application to feel undecided at some point in this career path. Actually, it may help you. During your interview when you are asked about why you chose to become a physician you can talk about the thought process you put into it, and how you explored all the options available in healthcare and chose the one that is the best fit for you.
EXPERIENCE: If you are still undecided, I do not recommend applying to medical school just yet. It may be that you need to find a job, big or small, working in healthcare to help you decide. This can also help you figure out if medicine, in general, is a good fit for you. The job opportunities can range from volunteering at a local hospital to becoming certified as a: CNA, EMT, or other medically trained professional.
PATIENCE. Most importantly remember, there is no rush! Becoming a doctor will take you through 4yrs undergrad, 4yrs doctoral training, and a minimum of 3 years residency, and that’s if everything flows perfectly in order. In the grand scheme of time, and the 11 years of minimal training, I promise that one semester or one year of exploring will not make a big difference in outcomes, but it may give you the reassurance or clarity to be completely committed to the path ahead of you, as well as a better applicant/interviewer.
As always, feel free to contact me if you have any questions.