Concerns and Questions About Transitioning from PA to MD/DO

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Session 75

This week’s question comes from a practicing PA who has some questions about transitioning from being a PA to starting medical school. These are great questions commonly asked not only by PAs but also by NPs and other nontrads who are in a healthcare-related field and want to make that switch.

[00:56] OldPreMeds Question of the Week:

“Just stumbled across this forum. Happy to see there are other nontrads getting back on the horse, too. I have a few logistical questions I hope you all could help me with.


I’m currently a practicing PA in emergency medicine in the ICU for around four years, looking to make the switch to medical school for a number of reasons, which I’m happy to elaborate on if needed. Three kids with a work-from-home husband, undergrad major of chemistry with cumulative GPA of 4.0 and a PA grad school GPA also 4.0. All med school prereqs essentially met via PA school prereqs. Haven’t taken the MCAT yet but started studying and plan to take it in the next one to two years.


  1. Would it be more financially wise for me to work an extra three to four years, pay off my PA school debt, and save up for cost of living with my PA salary before applying to and starting medical school? Or would it be better to start sooner rather than later, let the debt build on holy amounts of interest throughout med school and residency and have med school debt added on top of that knowing that I’ll be making more money sooner?
  1. Are there any legal issues or conflicts of interest against me picking up shifts as a PA while in medical school or working during med school in general? Do people do this?
  1. Do I really need to obtain shadowing hours given my experience practicing medicine every day?
  1. Should I be going back to school just so I can get science LORs (letters of recommendation) or would it be sufficient to obtain letters of recommendation from my physician colleagues and PA faculty members?”
Do I really need to obtain shadowing hours given my experience practicing medicine every day?Click To Tweet

These are great questions that a lot of students have when switching from a career in another healthcare-related field to medicine. Let’s dig into each of the questions and discuss them.

[03:14] Going into Med School with Debt from PA School

Is it financially wise to wait a couple years to pay off your PA school debt before going to medical school? Yes, it would be more financially wise to pay off your debt before accruing more debt. But this is a personal question that’s hard for anyone else to answer for you.

You really need to sit down with a financial advisor and look at all the factors here. Consider the lost income from giving up your PA work while attending medical school, your income as a resident, and finally, your income as an attending. What would it take to pay off all your debt first, and what that would that look like? Work out some different scenarios.

What would it take to pay off all your debt first, and what that would that look like? Work out some different scenarios.Click To Tweet

So, it seems more financially sound and wise to wait a couple of years. But whether or not it’s right for you, it’s a personal question that only you can answer. Do you enjoy your job well enough now to give it a couple of years? Are you dead set on going to medical school? If you wait a couple of years, are you going to question that decision? Should you just jump in now with both feet while you’re ready and your husband supports you? These are some things to think about.

[Related episode: PA to DO: What Path Should You Take?]

[04:40] Working as a PA While in Medical School

Is it possible to pick up shifts as a PA while in medical school? Yes, people do this.

I recommend that you talk to your medical school about this after you’re accepted. Make sure you’re accepted first, and then ask whether it is okay for you to pick up some shifts. Your ability to pick up shifts is going to be few and far between since medical school is going to be rigorous, so being able to work is going to be hard. But it is possible.

Your credentials, certifications, and schooling as a PA are fine. If you need to change state for medical school, you’d have to re-license yourself and all of that stuff that goes with moving to a new state. But you should be able to work as a PA. However, be careful with the clear delineations of what you’re doing and what scope of practice you’re practicing under.

Back in Episode 170 of The Premed Years Podcast, I talked with Brad who turned from PA to medical student and he shared his journey, why he was doing it. He talked about practicing as a PA during medical school.

[06:10] Do You Need Shadowing?

Do you need to obtain shadowing hours? Yes. Working as a PA side-by-side with physicians is not the same as “shadowing” a physician. While 99.9% of it is going to be stuff you’ve seen as a PA, just go shadow for 10 or 20 hours.

You don’t need a ton of hours. Just go shadow and see what that life is like when you’re not working and you’re able to just observe and take it all in. You’ve gotten through your education, and PAs work side by side with physicians, so you understand it. Still, get some shadowing hours so you can put it down on your extracurriculars.

Working with physicians as a PA or nurse is not the same as shadowing a physician.Click To Tweet

[06:57] Letters of Recommendation

Do you need to go to school just to get science LORs? No, you don’t. Most medical schools are going to recognize the fact that you’re a nontraditional student. If you ask them, they will say they won’t need those science LORs, so go ahead and use a supervisor or anybody else who will write a great letter of recommendation for you.

[07:26] Final Thoughts

These are great questions a lot of nontrads have, not just for PAs but for many others who have worked in the medical field. If you have any questions you want answered on OldPreMeds Podcast, go to our Nontraditional Premed Forum and register for a free account!