Are you wondering how to transition from PA to MD? Physician assistants and medical doctors have a lot more in common than you might think. PA vs MD is a common discussion in medical circles, and the reasons for why one might want to pursuit a DO or MD degree may be similar to the reasons why one would pursue a PA. For some, the physician assistant career path can also lead to an interest in a transition to a career as an MD. In this article, we will provide run down on the path to becoming an PA, and how you might transition from a PA to an MD.


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What is a Physician Assistant?

A physician assistant is a highly trained medical professional who works under the supervision of a practicing physician to provide assistance with tasks or even direct patient care. Though physician assistants cannot work independently, many physician assistants can perform complex tasks directed by their supervising physicians. By way of these delegated tasks, physician assistants can take on medical acts such as conducting patient interviews and physical examinations, provide counselling and education on preventative healthcare, order diagnostic investigations, treat illnesses, prescribe some medications, and even assist in surgeries. 

In some ways, a physician assistant can be seen as an extension of the supervising physician, a resident of sorts that does not leave the practice, who can help the physician streamline the process of getting care to their patients while focusing on the more complicated cases and complex treatments. As such, working as physician assistant can lead to a rewarding career that puts patient care and treatment first, while eliminating some of the more daunting aspects of working in medicine, such as carrying the responsibility and liability for treatments and maintaining the administrative aspects of a medical practice. 

Additionally, physician assistants serve an important role in the overall healthcare industry, as they help alleviate some of the burden placed on physicians by taking on tasks that physicians can direct without specifically overseeing in person. As such, they can help increase accessibility to healthcare and reduce wait-times for patients seeking care. And, though most physician assistants work in ambulatory clinical settings like primary care, many work in hospitals and subspecialties as well, thus permitting for a large scope of possible practice for those interested in the profession.

History and Scope

The role of a physician assistant was first envisioned in the United States in mid-20th century in response to the growing need for access to healthcare professionals. Taking inspiration from the accelerated training for physicians during wartime, the first academic program for training physician assistants was put together in 1965, with a graduating class of 1967. 

Since then, the profession of a physician assistant has grown steadily in the United States, and has become a popular and competitive career path. At this time, there are well over 250 accredited programs recognized by the Physician Assistant Education Association (PAEA) in the United States. As well, the current employment outlook for trained physician assistants is quite promising, as the profession is presently expanding, with more medical professionals and healthcare systems looking to hire physician assistants to increase access to healthcare and decrease costs associated with only employing physicians. 

The role has also started gaining momentum in international healthcare systems as well, with many countries creating and adopting academic programs to begin introducing physician assistants into the healthcare workforce. For example, Canada saw the first academic class of PA’s in 1984 through the Canadian Forces Medical Services School and has since established three more academic programs, as McMaster University, University of Toronto, University of Manitoba have started offering academic programs in the last two decades. Indeed, there is a growing interest in expanding the physician assistant workforce to combat the high costs and long wait-times in Canadian healthcare. As such, it can be a thoroughly rewarding and promising career for those interested in becoming a healthcare provider.

Learn the main differences between PA and MD below:

PA Training in USA and Canada

As I mentioned earlier, the physician assistant training and career path is considerably more developed in the United States thanks to the decades-long establishment and growth of the role in the healthcare system. With hundreds of academic programs all across the United States, the career is available to you regardless of your location. With that being said, these are highly competitive programs and often require years of preparation. 

For most programs in the United States, PA school requirements include completing a bachelor’s degree prior to the start of the physician assistant program. This is because the program technically grants a master’s degree upon completion (while programs in Canada grant a bachelor’s degree, though these two usually require a prior bachelor’s degree to start). In addition to the undergraduate degree, you must complete certain science-based courses, provide a GRE score for some programs, and often also have extensive previous experience in healthcare. 

Though many programs do not have minimum GPA requirements or have them pegged at 3.0, the competitive nature of these programs had led to averages such as 3.6 GPA for the admitted class. As well, many programs require applicants to have a minimum 1000-2000 hours of prior experience working in a healthcare setting in order to be eligible or competitive for the program. These figures amount to years of working full-time within healthcare, thus making the career of a physician assistant something that people can choose to pursue following some time in the healthcare workforce. 

Overall, the path to becoming a physician assistant often requires years of preparation, in addition 2-3 years of commitment to the academic program. Luckily, unlike becoming an MD, there is no requirement for residency, as graduates of the PA programs must only write a licensing exam prior to entering the workforce. 

It is also worthwhile to note that, though there are only a few academic programs currently available in Canada for pursuing this career path, American degrees are recognized and accepted in Canada at this time without additional certification.

Here's a quick recap of the differences between PA and MD:

Advantages and Disadvantages of Transitioning from PA to MD

Given the sheer amount of time, resources, and effort required to complete the certification for becoming a physician assistant, it is impractical to think of this career path as a mere stepping stone to becoming a medical doctor. Indeed, despite the similarities in training and scope of practice between a PA and an MD, a previous career as a physician assistant does not create any shortcuts in the training path to an MD. With that being said, it is entirely possible that after pursuing a career as a physician assistant, you may find yourself considering a switch to become a fully trained medical doctor. 

Advantages 

There are certainly advantages to pursuing a medical degree, even after you have already developed a career as a physician assistant. One of the key differences, of course, is the autonomy associated with position. As physician assistant, you are always only acting on behalf of your supervising physician. This means that, though you are trained and capable of carrying out certain acts in delivering medical care, those acts must be delegated to you by a physician in order for you to be legally allowed to carry out those tasks. After many years of experience providing medical care, you may find yourself craving the autonomy to provide the care without requiring supervision and permission, and also a developing interest in handling more complex medical problems and treatments. 

As well, there is a considerable difference in the pay associated with the two positions. A career as a physician assistant can provide a very comfortable salary, with an average of 106,000 USD received by American physician assistants, and a wider range of 80-120,000 CAD earned by their Canadian counterparts. In contrast, physicians can easily earn well upwards of 200-300,000 dollars a year, with a much higher salary available for specialists. If you are wondering how much physicians get paid, check out our list of the highest-paid doctors. Thus, while a physician assistant can have a very comfortable lifestyle, a career as a medical doctor is certainly considerably more lucrative.

Disadvantages

On the flipside, this same autonomy can also be seen as a disadvantage of the MD profession over the PA. Given that many self-employed physicians’ medical practices are essentially their businesses, this arrangement can often lead to an overwhelming amount of work associated with the upkeep and maintenance of the business, in addition to the actual practice of medicine. As such, while physician assistants can often enjoy a standard 9-5 workday, with a comfortable work/life balance, a physician is far more likely to work longer hours and experience burnout while overseeing every aspect of their medical practice. 

Similarly, the autonomy of providing medical care independently can also lead to an increasingly stressful experience. Since physician assistants are always acting on behalf of their supervising physician, they are only answerable to that physician. In contrast, the physician, whether acting themselves or delegating to others, always subsumes the responsibility of the care performed. As such, the physician always carries the liability for the care and potential problems stemming from it. Together with the responsibilities associated with running the multiple aspects of the practice, the career of a physician does carry a considerably higher level of responsibility and stress in contract to that of the physician assistant. 

As well, by transitioning from working as a physician assistant to a medical doctor, you may lose a certain level of flexibility associated with the type of medical care you can work in. Because physician assistants are often trained on the job for the specific fields of medicine in which they work, they can often end up working in multiple fields of medicine over the course of their careers. In contrast, medical doctors choose their specialty during the residency step of their training. As such, they cannot change their subspecialties without restarting the process and completing residency and even fellowships in the new field. 

Perhaps the biggest disadvantage of transition from working as a physician assistant to a physician is the actual time, money, and effort associated with making this transition. As I mentioned earlier, a career as a physician assistant does not provide any shortcuts in the path to becoming a fully qualified MD. This means that, if you are committed to transitioning from a PA to MD, you will have to dedicate years to preparing your application for medical school, be forced to take time away from working full time to attend school, take on the high medical school tuition costs, and then spend years completing residency (and even potentially a fellowship, if you are choosing to pursue a subspecialty) before being qualified to practice medicine independently. Given these considerations, you must be sure to thoroughly weigh your interests and commitment before undertaking the move from a physician assistant to a medical doctor.

Making the Transition

It may be possible that after careful consideration, you find yourself making the decision to transition from working as a physician assistant to a medical doctor. If this is the case, it is important to note that the process will take years of preparation and training, with the first few being dedicated to getting yourself accepted into an appropriate medical school. 

Recommendation Letters and MCAT

As with most other prospective students applying for medical school, your first steps will likely begin about 2 years prior to the year in which you plan to matriculate. Around this time, you should start considering who you reach out to for medical school letters of recommendation. Most med school applications require at least a couple of academic letters of recommendation, which may be somewhat challenging if you completed your schooling many years prior given your career as a physician assistant. 

At the same time, it will be important to reconsider your own medical school prerequisites as you start preparing for writing the MCAT. Since PA programs normally do not require an MCAT score, a large part of your preparation for entering a med school will be focused on acing this test. It is very likely that you will have completed the science courses that are recommended for writing the MCAT during your undergraduate degree, though again you will likely be facing the challenge of the sheer number of years that have elapsed between your bachelor’s degree prior to your career as a physician assistant and your current efforts to apply to med school. 

Because of this, it will be important for you to set aside time to revisit the materials covered in the three knowledge-based sections of the MCAT, namely the MCAT biology, chemistry, and psychology. Though some of your knowledge and experience as a physician assistant will be helpful in these sections, you will likely find yourself returning to your textbooks in order to refresh your memory.

Similarly, you will have to begin preparing for the challenging fourth section of the MCAT, the Critical Analysis and Reasoning Skills (CARS). Though this section does not test your existing knowledge, it does focus on your reading comprehension and analysis skills. As such, it is a highly demanding portion of the MCAT and requires a solid MCAT CARS strategy in the form of constant active reading, exposure to challenging texts, and working on your vocabulary. Since the MCAT CARS passages and questions are generally quite different from the types of texts we encounter in our day to day lives, one of the best ways to prepare for it is to practice with the samples provided by the AAMC. 

Ideally, it is preferable to write the MCAT with enough room to spare in your timeline that you would be to rewrite it if you need to. However, it is also important to wait until are you are ready to write the test well. To determine this, it is best to wait until you can score in the 90th percentile on a practice MCAT. 

Keep in mind that there are medical schools that do not require the MCAT, but these are few and far between.

Research the School

Another step in making the transition to an MD will be to find an appropriate medical school to submit your application. If you are applying to American medical schools, you can do this by familiarizing yourself with the Medical School Admissions Requirements (MSAR) database, which includes vital information about the requirements and medical school acceptance rates. Though there is a subscription fee, it is nominal, and provides you access to important information such as the academic and experience profile of successful applicants, and can help you determine your own chances at various schools. 

If you are applying to Canadian medical schools, you can research each of the schools to get a sense of your own fit into the program and your chances of success at each of them. You may note that both American and Canadian schools will differentiate students based on their residence, so be sure to check your eligibility as an applicant and how many students each school accepts from the category that you fall into, since this factor can really affect your chances of success.

Because med school applications are costly and time-consuming, it is important to only focus on schools that you are seriously considering attending, and that you can have moderate to high chances of success with. In addition to weighing your GPA and MCAT score (if available) against the statistics of the matriculating class, you can also reflect on how your previous experience compares to the profile of successful applicants. Here, you will find that your previous experience of working in a clinical setting as a physician assistant will be an important contribution to your overall background. However, you will also note that many medical schools place a lot of importance on community service and volunteering experience, so it will be important to develop those aspects of your medical school resume and application in addition to your employment history in healthcare.

Personal Statement and Secondary Applications

Although it may feel that your previous career as a physician assistant can create challenges in preparing for your application to med schools, you will find that your previous experience, both in healthcare and completing applications, will be quite helpful when actually going through the application cycle. If you are applying to American med schools, you will be required to submit a medical school personal statement and a secondary essays. Keep in mind that because of the rolling admissions process, it is important to submit these as early as possible. Canadian medical schools also require written applications, though they have set deadlines for submission rather than relying on the rolling process. 

The personal statement will be quite similar to the PA personal statement and other application requirements that you had to submit for the entry to your physician assistant program, so you will likely feel more confident crafting it. As well, your extensive experience working alongside physicians will be an important advantage in articulating your interest for why you want to become a doctor. You will likely also have important experiences to draw on in your secondary applications as well thanks to your history in medicine. While preparing your applications, be sure to review the best medical school application timeline to follow. 

Altus Suite and CASPer

Similarly, your past experience with your PA application and your work experience will be very helpful in the following steps of the application cycle should your personal statement and secondary applications prove to be successful, namely the potential Altus Suite you will be asked to complete and the interview process. Depending on when you were applying for your PA program, you may have already had experience completing the CASPer test since more and more PA programs are starting to incorporate it into their admissions cycle. Since CASPer is a Situational Judgement Test, your experience working in healthcare and observing physicians in action will likely help you navigate these situations, provided that you worked in environments that successfully demonstrates the values and skills identified in the AAMC Core Competencies and the CanMEDS Framework.

Note that even if you did not have previous experience with CASPer questions, you can still prepare for it by completing realistic simulations and soliciting expert feedback on the ways in which you handled the various situations and provided appropriate answers. 

Additionally, find out whether your medical schools of choice require you to complete the other two components of the Altus Snapshot and the Duet.

Check out some more tips about transitioning from PA to MD:

Interview Stage 

As you may have already noticed, much of the med school application process mirrors that of PA programs. As during your previous applications, the interview process will likely be the final stage of the admissions cycle. There are a variety of PA interview questions and types that different medical schools use for their admissions selection, including the Multiple Mini Interview (MMI), the AAMC Vita, and the traditional med interview. You may have had previous experience with these types of interviews through your applications to PA programs, and indeed, your previous experience working as a PA will provide important anecdotes and learning outcomes to discuss during your interviews. As well, you will be able to articulate your motivation to become a doctor, which is one of the key things that interviewers assess during these sit-downs. Nevertheless, it is important to come prepared for these interviews, both in terms of the experiences you would like to discuss and your interviewing technique. To do this, you can practice with sample medical school interview questions and solicit expert feedback for your answers.

In Medical School

At this stage in the process, you will likely soon find out whether you were able to secure a spot in a matriculating class at one of your med schools of choice. If all goes well, you will then take on the exciting journey of learning medicine through your classes and clinical rotations! Here, you will find that your experience as a physician assistant will certainly help you with the course materials and terminology, as well as practicing patient care and interaction. It may also be possible that you will have a clearer idea than your peers on the areas of medicine that are you most interested in pursuing, because you may have had previous experience assisting in these areas. 

Just as with the physician assistant training and licensing, you will have to pass licensing examinations at the end of your medical schooling. In the United States, these are the three-part United States Medical Licensing Examinations (USMLEs), and in Canada, the two-part Medical Council of Canada Qualifying Examinations (MCCQEs), MMCQE Part 1 and MCCQE Part 2. These examinations are some of the most challenging you will encounter in your career, so it is imperative to begin studying for them well in advance, while you are still in medical school. 

At the same time, as your time at med school starts to draw to a close, you will begin preparing your applications for a residency match. As an American student, you will be submitting your applicants to Electronic Residency Application Service (ERAS), while Canadian med students will be using the Canadian Resident Matching Service (CaRMS). Just like your med school applications, these will involve writing a personal statement, submitting references, and undergoing an interview process in order to secure a match with a residency program. Though residencies range in the number of years they will take to complete based on the field, this step should be the final in your path to becoming an MD, aside from some fellowships you might pursue for certain subspecialties.

Conclusion

The journey from PA to MD is both long and challenging. However, as a physician assistant who has his or her heart set on becoming an MD, you are well-positioned to succeed in this path, as you have a clear idea of what the career of an MD would look like and possess the skills and qualities that can help you thrive in it. And though the process will have many steps, you can always count on us to provide you with the resources to tackle each step of the way. 

FAQs

1. Do physician assistants do the same work as physicians, just to a lesser degree?

There is some overlap in the work that physicians and physician assistants do, as physicians will delegate some tasks to their assistants rather than completing them themselves. These can include taking patient histories, conducting physical examinations, and prescribing treatment. However, there are considerable differences in the responsibilities and scope of the work done by a physician versus a physician assistant.

2. Is the position of a physician assistant the same as a nurse practitioner?

Though physician assistants may be able to perform some of the same tasks performed by nurse practitioners, the key difference is that nurse practitioners are qualified to provide patient care independently, whereas physician assistants only work on behalf of the supervising physician.

3. How long does it take to become a physician assistant?

First you need a bachelor’s degree in order to get admitted into a physician assistant program. Usually, these training programs range from 2-3 academic years, with the first half spent on in-class education and the second on clinical rotations. Afterward, you are able to start working as a physician assistant following a licensing exam.

4. Can you fast-track training for an MD if you are already a physician assistant?

Unfortunately, no. The path to becoming an MD is the same regardless of whether you have worked as a physician assistant or not. However, you will find some steps of the process easier if you have this experience already. 

5. Do you still have to do residency to become and MD if you have already worked as a physician assistant?

Yes, the process for becoming a licensed MD will be the same. 

6. Is it easy to transition from PA to MD?

Because the applicationas well as the licensing steps remain the same even with a background of working as physician assistant, you can consider it to be as challenging as becoming an MD. However, the knowledge you bring as a PA will likely help ease some of the challenges of learning the material in medical school and providing patient care.

7. Will my clinical experience as a physician assistant benefit my med school application?

Your clinical experience will likely give you important experiences to discuss in your application letters, both in terms of your motivations to pursue medicine and your key experiences with medicine. It will likely also help you in the testing and interview portions of the application process, as you will be more familiar with situations that would require you to demonstrate important qualities required of a medical professional, as identified by the AAMC Core Competencies and the CanMEDS Framework.

8. Is it worth transitioning from PA to MD?

The answer to this question will be unique to you and your own interests and motivations for pursuing medicine. You will have to consider your own situation and whether you can reasonably accommodate the lengthy path to becoming a licensed MD.

9. What are the benefits and disadvantages of transitioning from PA to MD?

As an MD, you will have the autonomy to provide patient care and complex treatments independently, which is not something you would be able to do as a PA. As well, a career as an MD is ultimately more lucrative than that of a PA. However, there are also downsides to the transition, including the increased responsibility and stress, as well as the lengthy journey to becoming an MD.

To your success,

Your friends at BeMo

BeMo Academic Consulting

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