Paramedic or P.A. school?

[sparticus]

If Paramedic is boring then you will likely find P.A / Nursing boring as well. It really boils down to what you want to do. There is money in EMS, you won't make 150k+ unless you go overseas but you can make 60-90K with an EMS degree and 5-10 years of quality 911 system experience. Your Paramedic experience will serve you well as a Nurse and P.A. The most important thing is good solid Patient Assessment. I saw a P.A fumble through clearing someone off a backboard and i cringed, you can have all the medical knowledge in the world, but if you don't have the psychomotor skills to do the job then you are almost worthless to an ER department as you will undermine all they are trying to accomplish.

Hence why competitive P.A programs require at least 1000 clinical hours as a Nurse or EMT/Paramedic. Also I have observed that our ER Treat P.A's like glorified nurses, which sucks and i think they are underutilized in an already overburdened health care system.

 

[sparticus]

Stanford doesnt even require an associates degree to attend their PA school, they are huge on clinical exp. Granted most applicants already have their 4 year degree. Thats how PA school used to be until the whole you NEED to go to school thing started and bachelor degrees basically became associates degrees.

You spoke alot of truth there. a Masters does not make you a good P.A. Good solid Patient Assessment does though. You can learn that as an EMT, if you go above and beyond what you cert requires you to know

 

[Chewy20]

If Paramedic is boring then you will likely find P.A / Nursing boring as well. It really boils down to what you want to do. There is money in EMS, you won't make 150k+ unless you go overseas but you can make 60-90K with an EMS degree and 5-10 years of quality 911 system experience. Your Paramedic experience will serve you well as a Nurse and P.A. The most important thing is good solid Patient Assessment. I saw a P.A fumble through clearing someone off a backboard and i cringed, you can have all the medical knowledge in the world, but if you don't have the psychomotor skills to do the job then you are almost worthless to an ER department as you will undermine all they are trying to accomplish.

Hence why competitive P.A programs require at least 1000 clinical hours as a Nurse or EMT/Paramedic. Also I have observed that our ER Treat P.A's like glorified nurses, which sucks and i think they are underutilized in an already overburdened health care system.

Have shadowed Surgical PA's and found it to be interesting. Theres a lot of autonomy in that profession (can switch fields with no extra training), and you are right some ER PA's do not do much. On the other hand some PA's run ER's in rural areas, or can do quite a lot in the OR if their surgeon trusts them enough. The pros of not being on a box heavily outweigh the cons IMO (everyone is different). I am making in that pay range you gave, as a basic, and I do not find it to be to all that gratifying. For me it would be gratifying to be at the higher end of the medical food chain while earning more money. Again everyone is different, what I think is ideal, the next person will not.

 

[Brandon O]

150k is probably 99th percentile for PAs.

 

[JPINFV]

Have shadowed Surgical PA's and found it to be interesting. Theres a lot of autonomy in that profession (can switch fields with no extra training), and you are right some ER PA's do not do much. On the other hand some PA's run ER's in rural areas, or can do quite a lot in the OR if their surgeon trusts them enough. The pros of not being on a box heavily outweigh the cons IMO (everyone is different). I am making in that pay range you gave, as a basic, and I do not find it to be to all that gratifying. For me it would be gratifying to be at the higher end of the medical food chain while earning more money. Again everyone is different, what I think is ideal, the next person will not.

Of course the problem with being a PA for some people is that your essentially a glorified senior resident the rest of your life. The GI PA at my hospital essentially runs the consult service, but he still has to check in with the on-call attending at the end of the day. He's also dissatisfied at this point with the lack of autonomy that he applied for medical school this year and was just accepted at a program on the East Coast. If your (generic "your") the sort of person who wants autonomy and not being at the whim of your supervising physician (and I'll grant that the level of oversight varies significantly), then PA school may be a poor choice.

 

[Chewy20]

Of course the problem with being a PA for some people is that your essentially a glorified senior resident the rest of your life. The GI PA at my hospital essentially runs the consult service, but he still has to check in with the on-call attending at the end of the day. He's also dissatisfied at this point with the lack of autonomy that he applied for medical school this year and was just accepted at a program on the East Coast. If your (generic "your") the sort of person who wants autonomy and not being at the whim of your supervising physician (and I'll grant that the level of oversight varies significantly), then PA school may be a poor choice.

Better than being called a "glorified taxi driver."

I have thought about med school, just don't know if I want to spend that much extra time in school then deal with residency. When the time comes I will more than likely apply to both, and if I happen to get into a few schools then weigh my options.

 

[JPINFV]

If Paramedic is boring then you will likely find P.A / Nursing boring as well. It really boils down to what you want to do. There is money in EMS, you won't make 150k+ unless you go overseas but you can make 60-90K with an EMS degree and 5-10 years of quality 911 system experience. Your Paramedic experience will serve you well as a Nurse and P.A. The most important thing is good solid Patient Assessment. I saw a P.A fumble through clearing someone off a backboard and i cringed, you can have all the medical knowledge in the world, but if you don't have the psychomotor skills to do the job then you are almost worthless to an ER department as you will undermine all they are trying to accomplish.

Hence why competitive P.A programs require at least 1000 clinical hours as a Nurse or EMT/Paramedic. Also I have observed that our ER Treat P.A's like glorified nurses, which sucks and i think they are underutilized in an already overburdened health care system.

1. Just because someone finds EMS boring doesn't mean that they'll find PA or nursing boring. EMS isn't the end-all be-all of medicine.

2. Good patient assessment is always going to be at the whim of how much the person doing the exam understands the components and what those components are actually saying. Also, how often does that PA clear a board off of someone?

3. In general, given a non-critical access/no one else wants the job situation, the PA should be at least running the basics (short conversations) by which ever physician's name is going on the chart prior to final disposition.

 

[JPINFV]

As a ER P.A you will be doing the same motor skills as a Paramedic. A good Paramedic can diagnose just as well as a P.A can. A mediocre Paramedic will just bring bodies to the ER drop them off give a lame report and head back out the door. You have to decide what type of Paramedic you want to be. That brings me to my next point, EMS has a huge disparity between quality of education, giving rise to our low pay. Our Paramedics are paid well. Zero experience and no degree starts you off at about 35k a year. Within 5 years you can be making close to 50k (EMS Rewards Experience) with Overtime some guys make 100K.

P.A school is a great option, you will learn more, and you may have the quality of life you are looking for surgical P.A's can make 150K. However Paramedics do the job, because no one else wants to. To be a Paramedic is to answer a calling. I never understood why guys would allow themselves to get so bitter to the point they deride their profession. A Paramedic is a noble job, be proud of it.

1. Any PA worth their salt should be able to run circles around the average and even above average paramedic in terms of diagnostic ability and being able to consider differentials. Any PA that can't is more a reflection on the PA than the paramedic. You simply can't diagnose something you've never heard of before.

2. Let's be honest, most of medicine is a "calling" if you want to put it that way, and the sacrifices can be dramatically different. However, neither that nor how noble a job will necessarily make up for all of the problems associated with EMS (or medicine in general).

 

[Brandon O]

3. In general, given a non-critical access/no one else wants the job situation, the PA should be at least running the basics (short conversations) by which ever physician's name is going on the chart prior to final disposition.

This is not necessarily the case. Highly dependent on the state (i.e. oversight regulations), facility/group, and individuals involved. For many supervision consists of consultation as-needed only.

(This is a bit like EMS systems in that everyone does it very differently and I think everyone tends to assume the way they're familiar with is the only way...)

 

[sparticus]

1. Any PA worth their salt should be able to run circles around the average and even above average paramedic in terms of diagnostic ability and being able to consider differentials. Any PA that can't is more a reflection on the PA than the paramedic. You simply can't diagnose something you've never heard of before.

2. Let's be honest, most of medicine is a "calling" if you want to put it that way, and the sacrifices can be dramatically different. However, neither that nor how noble a job will necessarily make up for all of the problems associated with EMS (or medicine in general).

I disagree on both points you make here. I know several Paramedics who are brilliant. You take your knowledge where you want to take it. What do you do on your down time do you sleep or study meds and differential diagnosis. When you write your reports? do you use medical terminology or layman joe off the street. There are alot of mediocre lackluster paramedics who are burnt out who just don't care about the job and how important it is.

This concept goes for every job.. In fact like chewy states up until a few years ago a P.A did not need a BA so you had P.A working w/ 2 years of college

secondly not all medicine is the same if you have a calling to be a Paramedic. It's what you want to do you find Satisfaction in your job no matter the cons. EMS is a job that anyone can do but not many want to do it, that alone should be noble in itself. I left a 80K bank Job to work EMS.

Also I would home a P.A would know how to clear spinal working in a ER room in a system that have liberal spinal immobilization protocols

 

[sparticus]

Paramedics are like special teams. You can't win games without them unless you want that Cardiac Arrest or multiple GSW to the chest to walk into the ER by themselves...

Also I tell all my buddies who complain about getting that headache, Stumped toe or ETOH freq flyer ... "Dude...Look on the bright side...at least we only have to deal with them for 20-30 min a Nurse, PA or MD has to deal with them for hours lol"

 

[sparticus]

Of course the problem with being a PA for some people is that your essentially a glorified senior resident the rest of your life. The GI PA at my hospital essentially runs the consult service, but he still has to check in with the on-call attending at the end of the day. He's also dissatisfied at this point with the lack of autonomy that he applied for medical school this year and was just accepted at a program on the East Coast. If your (generic "your") the sort of person who wants autonomy and not being at the whim of your supervising physician (and I'll grant that the level of oversight varies significantly), then PA school may be a poor choice.

I agree w/ you here

 

[Ewok Jerky]

"Dude...Look on the bright side...at least we only have to deal with them for 20-30 min a Nurse has to deal with them for hours lol"

Fixed that

 

[Ewok Jerky]

If Paramedic is boring then you will likely find P.A / Nursing boring as well. It really boils down to what you want to do.

Absolutely disagree. EM is one branch of medicine. And for all the adrenaline of both the field and the ED, bread and butter Emergency is a handful of life threatening illnesses. Anything else is punted to medicine or primary care. If you like procedures ok it's a little more interesting.

I was getting bored with EMS, not burnt out, when I got into PA school. Each class during didactic was more interesting than the last. During clinicals I would have taken a job with any one of my rotation sites.

 

[Chewy20]

This concept goes for every job.. In fact like chewy states up until a few years ago a P.A did not need a BA so you had P.A working w/ 2 years of college

I know several Paramedics who are brilliant.

1. Yes I said that, and it is true. But PA's coming out of a two year program know a heck of a lot more than what you learn in medic school. A LOT more. PA is still a two year program, you can get a bachelors in under water basket weaving as long as you have the pre-reqs.

2. Yeah so do I, yet the most brillaint medics you have seen have probably spent their whole career in EMS. Its deffinitly not the norm.

3. I feel like you are way to happy of a person. How long have you been in "EMS"?

 

[JPINFV]

I disagree on both points you make here. I know several Paramedics who are brilliant. You take your knowledge where you want to take it. What do you do on your down time do you sleep or study meds and differential diagnosis. When you write your reports? do you use medical terminology or layman joe off the street. There are alot of mediocre lackluster paramedics who are burnt out who just don't care about the job and how important it is.

The plural of "anecdote" is not "data."

secondly not all medicine is the same if you have a calling to be a Paramedic. It's what you want to do you find Satisfaction in your job no matter the cons. EMS is a job that anyone can do but not many want to do it, that alone should be noble in itself. I left a 80K bank Job to work EMS.

...and with medicine the training/education time frame is so long that many people enter it not realizing what it takes, realize too late that it's not what they want, but end up being stuck and burning out.

Also I would home a P.A would know how to clear spinal working in a ER room in a system that have liberal spinal immobilization protocols

How long has that PA worked there?

Also the ED doesn't care what the EMS protocols are. They're free to make their own standards on clearing c-spine.

 

[OnceAnEMT]

The plural of "anecdote" is not "data."

Also the ED doesn't care what the EMS protocols are. They're free to make their own standards on clearing c-spine.

Well, I wouldn't go as far as "not care" as it certainly is communicated, specifically with Stroke and STEMI alerts. Where I am at, if they call either of those from the field, we call it and thus page it out. Similar process with trauma criteria, though that tends to waver a bit more. Now, c-spine... it doesn't matter if L5 is in your abdomen, the board is coming out. We will leave c-collars until cleared by palpation or imaging if iffy, and will put collars on people we suspect (POV or EMS Pts). No one holding manual in-line stabilization or anything though.

I am honestly surprised this thread took off like I did. I personally cannot even see it reasonable to compare PA and Paramedic. They are 2 completely different fields, completely different education systems and curriculum, and completely different scopes. If you want to (and have the grades, hours, and pre-reqs to) commit to a little more education and have the opportunity for more variability in your life while maintaining an easy going schedule (if you want it), and always be "second", go PA. If you want a guaranteed faster-paced career with less pay and more stress but with outlandish benefits that just may complete your life, and the opportunity to call your own shots and make your own decisions on your own scene with your own patient with a team under you, go Paramedic.

Completely different things.

 

[JPINFV]

Well, I wouldn't go as far as "not care" as it certainly is communicated, specifically with Stroke and STEMI alerts. Where I am at, if they call either of those from the field, we call it and thus page it out. Similar process with trauma criteria, though that tends to waver a bit more. Now, c-spine... it doesn't matter if L5 is in your abdomen, the board is coming out. We will leave c-collars until cleared by palpation or imaging if iffy, and will put collars on people we suspect (POV or EMS Pts). No one holding manual in-line stabilization or anything though.

Also, at least at my hospital, any one who does remain in a collar is switched to a philly collar... and not the adjustable collars left at no-neck level that most of the EMS patients are brought in on.

 

[Ewok Jerky]

I am honestly surprised this thread took off like I did. I personally cannot even see it reasonable to compare PA and Paramedic. They are 2 completely different fields, completely different education systems and curriculum, and completely different scopes. If you want to (and have the grades, hours, and pre-reqs to) commit to a little more education and have the opportunity for more variability in your life while maintaining an easy going schedule (if you want it), and always be "second", go PA. If you want a guaranteed faster-paced career with less pay and more stress but with outlandish benefits that just may complete your life, and the opportunity to call your own shots and make your own decisions on your own scene with your own patient with a team under you, go Paramedic.

Completely different things.

You obviously haven't met very many PAs.
this is a popular topic because the original PAs were medics trained by physician to provide rural primary care. So no, they are not 2 completely different fields.

 

[OnceAnEMT]

You obviously haven't met very many PAs.
this is a popular topic because the original PAs were medics trained by physician to provide rural primary care. So no, they are not 2 completely different fields.

If you're looking at PAs in the sense of emergency medicine or critical care, sure, but you're ignored the possibility of an OB or family or sports medicine PA. You're right, I haven't met many PAs. But I do know that the profession is really seeing light now adays and the "original PAs" are finding competition it becomes more saturated with providers.