Name: Doctor vs PA vs NP | Which is Right for You?
Uploaded: 2021-09-11T17:40:31.000Z
Duration: 12 min 23 s
Description: Thousands of YouTube videos with English-Chinese subtitles! Now you can learn to understand native speakers, expand your vocabulary, and improve your pronunciation...

Doctor, nurse practitioner, and physician assistant. Three different healthcare paths

with three overlapping but distinct outcomes. How can you know which is right for you? I'll

help you decide. Dr. Jubbal, MedSchoolInsiders.com.

Many students interested in healthcare and medicine find themselves deciding between

becoming a physician with an MD or DO, versus going down the physician assistant or nurse

practitioner path. After all, they all have substantial overlap, however they're also

substantially different. If you're the type of person who would be happy being a physician,

you may not be as happy as a PA or NP, and vice versa. Do note that all three are fantastic

professions, and no single one is better than the other. You simply need to decide what

you value most and choose accordingly. This is a big picture overview of the three

paths. If you want to dive deeper into any single one, we have So You Want to Be episodes

for physicians, PA's, and NP's. Links in the description.

Let's start with the different training paths, as this is one of the biggest differentiators

and a big reason many choose the midlevel path over the physician path.

The doctor training path, whether MD or DO, is the longest by far. After your 4 premed

years in college, you'll complete another 4 years of medical school followed by 3 to

7 years of residency in your intended specialty. If you want to further subspecialize with

a fellowship, add one or more years after that.

Both midlevel training paths, whether PA or NP, are comparatively much shorter.

To become a physician assistant, you'll enter physician assistant school after college,

which is 2 or 2 and a half years in duration. Whereas in medical school, you spend 2 years

focused primarily on didactics and 2 years focused primarily on clinic time, in PA school

you'll have just one year of didactics and the remaining 12 or 18 months focused on clinical

exposure. After that, there's no residency, and you're free to start practicing as a PA

immediately. To become a nurse practitioner, you can choose

from two paths: traditional or direct entry. The traditional pathway involves first earning

your BSN, ABN, or MSN to become an RN after taking your NCLEX exam. Next, they attend

a master's or doctorate program to become an NP. If you attend a full time master's

program, it will generally take 2 years, but if you are undergoing a part-time DNP program,

it can take up to 5. If you were to major nursing in college and take your NCLEX, you

could become an RN soon after graduation and become a fully trained NP just 2 years later.

The second pathway, or direct entry nurse practitioner programs, are for those who earned

a bachelor's degree in something else. These are 3-5 year programs, where you will take

both the NCLEX to earn your RN but also complete a master's or doctorate program to become

an NP. It's not just the duration of training, but

also the competitiveness and rigor of each path. Getting into medical school is by far

the most competitive of the three. At some schools, like at UCLA when I was there, over

80% of premeds on the first day of college are no longer premed by graduation time. And

of those who do ultimately apply to medical school, only 40% get accepted. The average

matriculant stats are 83rd percentile on the MCAT and a 3.73 GPA.

After medical school, PA school is next in the order of competitiveness. The average

GPA for accepted PA students is 3.5 and they average around the 40th to 50th percentile

on the GRE. Note that they do have a lower average acceptance rate at 33% of all applicants,

and this sometimes confuses students into thinking PA school is more competitive. When

you consider the outcome if the average premed with higher stats applied to PA school, or

the average pre-PA student with lower stats applied to medical school, it generally clarifies

any confusion. Do note that many PA schools also require

over 1,000 hours of direct patient healthcare experience prior to matriculating. This doesn't

make it any more competitive, but you will need to spend considerable time putting in

those hours. While premeds don't need 1,000 hours of direct patient experience, they do

need to put in several hundreds of hours across multiple extracurriculars including clinical

experience, research, volunteering, leadership, and others.

NP school is the least competitive of the three and it has the loosest requirements.

Some programs require 1 to 2 years of prior nursing experience, while others don't require

any. GPA isn't highlighted as a primary factor, with most GPA cutoffs around 3.0, but this

isn't a hard rule. Middle Tennessee State University, for example, is reported to generally

accept applicants with a GPA of 2.9 or greater. When it comes to rigor, your clinical years

in medical school and your residency years will be extremely trying. The norm is to be

working 70 to 80 hours per week, but expect over 80 hours in most surgical specialties.

With the PA and NP training paths, you won't be expected to put in such long hours or for

so many years. In terms of cost, medical school is the most

expensive, followed by PA school, followed by NP school. The average annual tuition for

medical school is $40,000 to $60,000 and graduates have an average debt burden close to $200,000.

The average annual tuition for PA school is about $45,000 with average graduating debt

burden approximately $110,000. NP schools average between $18,000 to $32,000 per year,

with the average graduating debt burden between $40,000 and $60,000 depending on the source.

If you're finding the video helpful, let me know with a thumbs up, and consider gently

tapping the subscribe button and notification bell with surgical precision.

Considering the training paths, it's natural to assume that physicians have the deepest

knowledge and expertise when it comes to the body and how to treat its various ailments.

If you assume that, then you would be correct. Not only do physicians spend the most time

focusing on the foundations, but they also spend several years focusing on their specific

specialty in residency. The knowledge of midlevels is substantial,

but as the name describes, is less than that of physicians. NP's and PA's spend far less

time in training than physicians, and therefore don't have the same depth of expertise.

Physician assistants follow the medical model, similar to physicians, while nurse practitioners

follow the nursing model. But note that after completing PA school or NP school, you're

fully trained and able to join the work force, without any required residency for specialty

training. PA's and NP's get a great deal of their specialty training on the job after

joining a practice. While this is very useful in getting up to speed quickly with pattern

recognition for common presenting concerns, you won't be well equipped to identify and

manage rare or complex conditions. Given the on-the-job training, it's also much

easier to change specialties later in your career if you get bored of one or want a change

of pace. That's not feasible to do so for physicians, who would have to reapply to residency

and complete another 3 to 7 years of structured training. PA's are considered to have the

most flexibility and are sometimes found in surgical specialties, either handling pre-

or post-operative patient floor work or assisting in the operating room. NP's have flexibility

as well, but you'll need to be intentional with which program you attend, as each program

trains you toward a specialization, such as primary care, acute care, family, women's

health, and so on. If you are interested in surgery, note that

only surgeons with an MD or DO are qualified and have the sufficient knowledge and expertise

to perform surgery. With the PA or NP routes, the most you'll be able to do in the OR is

be first assist, helping the surgeon by retracting, suctioning, suturing, and the like. That's

the level of responsibility of a medical student or junior resident. Which brings us to the

hotly debated topic of scope of practice. Scope of practice refers to what each type

of professional is expected and allowed to do.

Historically, the NP and PA training paths were created to address a shortage of primary

care physicians and were to serve as an adjunct to physician-led care, not as a replacement.

In this model, NP's, PA's, and physicians all work together in harmony in service to

the patient. Since physicians have the most robust knowledge and training, midlevels were