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thinking about med school after PT school
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thinking about med school after PT school - November 1, 2004 9:03:00 PM
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wjPT
Posts: 33
Joined: October 11, 2004
From: San Diego, CA
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Just wanted to find out from anyone on this forum who has made the transition from PT or other allied health professions to med school; how was the transition and why did you decide to attend med school.
I am seriously considering going to med school after I finish up the requirements for admission, while I work for 1-2 years as a newly graduated PT. I just came to the realization while in PT school that I wanted to have the capacity to fully care for a patient, whether it be as an ortho doc performing surgery or a PM&R doc providing comprehensive musculoskeletal medical care.
I really do enjoy PT and the care that we provide our patients, but I feel as if I will be wanting more knowledge and education in the field of medicine, of which I could only receive as an MD/DO.
Any insightful info would be appreciated
warren
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Re: thinking about med school after PT school - November 2, 2004 2:38:00 AM
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Dr.Wagner
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From: Indianapolis
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I made the transition after graduating from PT school when I was 25 years old in the mid 90's. I was actively searching for more in the way of clinical practice, academics, and exposure. I wanted both more responsibility and the ability to perform life saving skills. I wanted a larger rush than the one felt from the draft of a hydrocollator. In doing so, I knew I would be leaving one of the easiest schedules and lifestyles in healthcare to the most unpredictable lifestyle filled with multiple stressors. I knew that my weekends would no longer be free to spend as I wish. I wanted the challenge and I am glad that I took it. You certainly have to put your life on hold and the benefits are delayed but the transition from one field to another makes for the best doctor...so I would have it no other way.
My best man at my wedding was also my roommate from PT school, so I don't think I have left my old life too far behind.
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Dr. Wagner DO
Moderator of Medical Complexity Forum
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Re: thinking about med school after PT school - November 2, 2004 4:41:00 PM
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l_a
Posts: 38
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Hello Warren,
I have one friend who is an MD and another in DO School. They were both PT's previously.
It seems to make for a great orthopaedic physician bc of some of the background you bring with you.
Dr. Wagner is right, and can certainly speak to it a lot more than I can.
Some of the two most often hearad negatives are:
Longer hours
Increasing Malpratice insurance costs/litigagtion
The positives are:
More respected than a PT
At least 3x the pay of a PT
Much more automony
Just as an opinion, I don't know if you just got done with PT school and working or not, but from my point of view, if you are intelligent
enough, go for it!
although Dr. Wagner is right about the hrs as a PT, they may not be as good as Dr Warren remembers when he was out in the field!
At least not in this part of the country.
Most PT's have to work sometime in the weekend and into the evening.
Although I'm sure Dr. Wagner's hours are far worse than the obove mentioned, is compensation equally dwarfs a PT's! (according to the Dept. of Labor)
Also, just to clear up a few things about the currrent state of PT, PT isn't as laid back as it used to be. Most places can be pretty stressfull. Most of the time your trying to get squeezed for more productivity and less concern about pt care! Unfortunately the days of the layed back clinic seem to be over!(not trying to compare it to trying to save a life though)
After all that rambling, basically any profession will have it's goods and bads, the best way is probably to shadow a doctor in the discipline you wish to practice in because anyone can make their profession sound as good, or as bad as they want, but there is nothing like seeing it for yourself!
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Re: thinking about med school after PT school - November 2, 2004 6:06:00 PM
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Dr.Wagner
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From: Indianapolis
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I think we absolutely agree...I guess the biggest thing about the schedule is that the decisions being made in PT have less medico-legal risk, generally deal with less invasive procedures, and most often deal with less mortality and morbidity decisions, and generally at a more "planned" schedule. I can tell you there is 100% more pressure on physicians and residents than I ever experienced as a PT...of course it is relative.
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Dr. Wagner DO
Moderator of Medical Complexity Forum
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Re: thinking about med school after PT school - November 2, 2004 7:35:00 PM
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wjPT
Posts: 33
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From: San Diego, CA
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Dr. Wagner & MAPT,
thanks for the very personable response in relation to the dilemma that I know face. I am currently a 3rd year DPT student and I really have found that becoming a physician is of great interest at this time in my career. I could see myself having a great career in PT, but I feel that I will always wonder what med school and becoming a physician would have been like.
I sincerely feel that PT will challenge me for 5-10 years, but medicine would challenge me for a lifetime. I am currently 27, and this is the only time that I would want to start med school, knowing that my next decade of life will be one of the greatest challenges in my career in healthcare.
I appreciate the insightful comments,
warren
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Re: thinking about med school after PT school - November 2, 2004 8:17:00 PM
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Dr.Wagner
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From: Indianapolis
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Do it now...you are at a crossroad in your life.
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Dr. Wagner DO
Moderator of Medical Complexity Forum
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Re: thinking about med school after PT school - November 3, 2004 10:50:00 AM
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chiroortho
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My two cents would be that a PT would make a fantastic orthopedist, or even better PM&R doc.
I've noticed that a number of DOs in town are PM&R, and from all accounts are excellent.
It would be a waste of your hard-earned PT training in my opinion to not at least give those two specialties some thought, in my ever so humble opinion.
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Greg Priest, DC, DABCO
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Re: thinking about med school after PT school - November 3, 2004 8:21:00 PM
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wjPT
Posts: 33
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From: San Diego, CA
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Greg,
Both orthopedics and PM&R are the specialties that interest me the most. If I do go on to med school, I will have to decide which one suits my interest the most. Currently I am leaning towards ortho, as surgery is very interesting.
warren
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Re: thinking about med school after PT school - November 4, 2004 8:29:00 PM
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DC/med student
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I have to say that med school is much more challenging, much more time consuming and much more interesting than chiro college ever was. It is also much more stressful. You deal with a lot of bad situations people get into and you will see death. It is serious stuff at times.
I am like a kid in a candy store. I love every aspect of medicine I have done. Medicine is such a broad field that you may find an interest you didn't know you had. You may find that you are not so interested in ortho or PM&R when you get into your clinical rotations because something else appeals to you. I really enjoy internal medicine (cardiology, respirology, nephrology, hematology, endocrinology, infectious disease, neurology, rheumatology, GI), psychiatry, OB/GYN (delivering babies is fun!), pediatrics, and all my surgical rotations (opthalmology, ENT, plastics, general surgery, neurosurgery, urology, ortho). Family medicine and emerg let you do some of everything to a certain extent.
You are going to have to do rotations in all the areas of medicine, so your knowledge about health and disease in all aspects will increase and I'm sure you'll find as I have that there is a heck of a lot to learn no matter what previous education you had before med school. So, if you know that ortho or PM&R is for sure all you want to do, you will have to have to be ready to learn a lot about things you may not be interested in along the way.
I have to say that although I loved my orthopedics rotation, I found it a bit boring compared to other areas of medicine I had never had exposure to before. It was fun to put in pins, screws and plates though! I like power tools, so ortho was fun.
What I realize about any career in medicine is that it is no short cut to success. It is a tough grind and a lot of years. To be a surgeon, you have to love being in the OR. You are going to be spending A LOT of time there standing in one place at the table for hours and hours, doing emergency surgery in the middle of the night, dealing with crisis, spending 100+ hours a week for years AFTER finishing med school while you do residency. Most people also do fellowhips now so that is even extra training after residency.
PM&R is considered one of the easier residencies in terms of time and on-call requirements. Personally, I think it might get boring and frustrating. You are dealing with tough cases that a lot of the time don't tend to get much better. At least in Ortho you can fix stuff!
Anyway, don't delay getting going in med school, if that is really what you want to do. It is a long haul and the sooner you start the sooner you are done. Med school is 4 years, residency is 5 years and fellowhip is 1 or 2 more. You are looking at a decade of training ahead of you!
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Re: thinking about med school after PT school - November 5, 2004 7:24:00 AM
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Dr.Wagner
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From: Indianapolis
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DC/Med student brings up fabulous points, and ones he/she has learned. Primarily going into med school with preconceived notions of "what you want to do" sometimes turn out flat (I loved ortho PT, but HATED the OR and decided that orthosurgery was not for me...I also felt PM&R was too boring).
You will certainly enjoy medicine, be challenged like never before and sometimes feel at your wits end.
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Dr. Wagner DO
Moderator of Medical Complexity Forum
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Re: thinking about med school after PT school - November 5, 2004 12:14:00 PM
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wjPT
Posts: 33
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From: San Diego, CA
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DC/med student,
Thank you for the info provided regarding med school. Ortho and PM&R have peaked my interest as possible specialities, but I plan on remaining open to all of the various specialities once I get into med school. I have no definite plan for any specific specialty currently.
warren
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Re: thinking about med school after PT school - November 6, 2004 8:47:00 AM
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Rankin
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From: Arkansas
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wjPT:
This is my experience: I "went" to med school after being a PT for two years. The quotations are there because I just spent a week in orientation. The day came to pay tuition, and I bailed. I was 29. I had identical motivations to go to med school as you, and I often regret my decision to not attend, as the extra respect, income, autonomy, etc would be nice. I decided not to attend, though, based on many converations at that time with MD's, med students, ex-PT physicians, and some serious introspection. Basically, I didn't have the dedication I knew it would take. And, not being incredibly smart (just kinda smart), I knew doubted I was up for the chronic challenge the next ten years would give me. Funny, at that time ('94) EVERY PT I talked to thought medical school was a terrible idea, as did most of the MD's, med students,etc. It was still the high times for PT's, I suppose. Interesting how that has changed. Anyway, go for it...
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Re: thinking about med school after PT school - November 6, 2004 11:12:00 AM
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DC/med student
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I was 33 when I started medicine. I am 36 and in my final year of med school now. It is definitely harder going to school now that I am married with wife and kids. The big difference now is that I'm in my clinical years of med school and I have one or two nights a week that I must do on-call coverage in the hospital overnight. That makes for 24 to 30 hour shifts. About every second weekend is taken up with at least one day of call that is a 24 hour shift. My kids ask me every morning before I leave if I'm on call or if I'll be home to tuck them in bed. Many days I leave before they are awake and get home after they are in bed. Some rotations are definitely worse than others, though. It is hard on a family, and you all have to be 100% committed to what you are doing. It is manageable for us but it takes a lot of teamwork and supporting each other if you are married.
Chiropractic was never any weekends and certainly no overnights or the long shifts like I'm doing now. I doubt PT makes students do that anywhere, so that is a big adjustment. Makes for very little free time, but it is still worth it to me. You won't believe how much there is to learn! When you are on call, you see and learn a lot so it is very valuable experience.
I live in Canada and we have a severe doctor shortage here which makes for a very secure future in medicine. Although the docs up here complain they don't make enough money, they actually do quite well when you look at the big picture. Dealing with government hassles for our socialized medicine is actually probably easier than dealing with all the different insurance companies that is the situation in the U.S.
Funilly, when I was a junior in college doing my undergrad, I was trying to figure out what to do with my life. I asked a lot of MD's, PT's and chiros what they liked and didn't like about their jobs. The MD's convinced me not to apply because of politics, government interference etc etc! I wish now I hadn't taken their advice! A lot of MD's can be negative, but it will always be a good field to be in if you are ready to face some adversity along the way and don't go into it with rose coloured glasses on. The chiros seemed happy with what they were doing, but I didn't realize what a weird profession it was until I was in it. The PT's I talked to were postitive, but for some reason I never applied to PT. I guess my ego got in the way and I wanted to do something where I would be called "doctor" not realizing how chiros are percieved as quacks by the rest of the health care professions. Oh well, live and learn.
I forgot to mention a couple of rotations that I enjoyed quite a bit that are good for people who like to do things with their hands: anesthesia and dermatology. There is a lot of minor surgical procedures in dermatology, and it is quite an interesting field. Anesthesia is a very technical specialty that is very interesting to anybody who has an interest in pain. You have to love being in the OR to be an anesthetist, but at least you get to sit down most of the time! However, when things go bad, they can go bad very, very fast so it can a very stressful job.
As for me, I'm going into Family Medicine, which is a 2 year residency in Canada. I know I just can't handle the longer residencies in my family situation. I also miss having a job (income) and my own office. Being a student again after working for 7 years is big mental adjustment to make.
Another consideration when applying to medicine to remember is that there is a very strong heirchy in medicine, kind of like the military! Speak when spoken to! Do your rounds and know everything about your patients! Anticipate what your senior is going to want to know about the patients you are covering! When you are a medical student on the wards (called a clinical clerk) you take orders from everyone and get no respect because you basically are useless! When you are resident, you have so much to do and you always have to do whatever your senior resident or staff physician tells you. You have to check your ego at the door when you are working your way up through the ranks in medicine. I find that there really are a lot of brilliant people in medicine (but there are also some people you wonder how they ever got in!) so there is also the "little fish in a big pond" syndrome.
It is a big decision to make. For me, it is worth the effort. I enjoy the challenge and look forward to my future career.
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Re: thinking about med school after PT school - November 6, 2004 12:12:00 PM
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wjPT
Posts: 33
Joined: October 11, 2004
From: San Diego, CA
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DC/med student:
I also am married, but without any kids for now. It sure does sound like balancing your family at home and med school requirements are difficult, but achievable if approached correctly. When I start med school, my wife and I will have to discuss when we want to start a family, as we are not going to wait until after residency.
Thanks for the info on your personal experiences, as they sound similar to what my experiences might be like in the very near future.
warren
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Re: thinking about med school after PT school - November 13, 2004 6:14:00 PM
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Augustine5I
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From: NJ
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wjPT,
Just think how great it will be once you are a licensed physician! You will then have the power to write prescriptions of "back pain" and "sciatica".
You can then leave the actual treatment of the patient to me (as you circl off all the various items on your prescription pad).
All this once the medication and injections you have prescribed have failed........and you turn to the help of your trusty PT for the relief of "your" patient.
I disagree that your education as a trained therapist will benefit you in some way. Perhaps if you were a seasoned therapist.......
It will not be long before physical therapists have the autonomy across the land to treat and receive reimbursements.
A physcian's prescription of "back pain" or "cervical strain" is of little value. The patient could tell me they have back pain free of charge. It requires the skilled assessment of the therapist to truly seek the patient's impairment and treat accordingly.
You will see the patient every four to six weeks. We will see them three times a week. Prepared to be out of touch.
Another thing. Insurance companies have already knocked out the legs of the once almighty AMA. Even if you prescribe it.....they may or may not authorize it. So much for power and autonomy.
Wagner, I feel sorry for any patient you ever treated as a therapist if you can sum up your experience as a "rush" from a hydrocullator. YOu must have been quite skilled. Not everyone works at a PT Mill of Hot packs and cold packs as you once did. Perhaps your experience as a therapist might have been more rewarding if you did more than paliative treatments. You are a sell out and I take offense to your comments. So would your roommate.
Respectfully,
Tom
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[URL=http://www.colonialpt.com]www.colonialpt.com[/URL]
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Re: thinking about med school after PT school - November 14, 2004 7:52:00 AM
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Dr.Wagner
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From: Indianapolis
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YO augustine...mellow out man, it was a joke. Even when I was a senior student in PT all the PT's made the same joke about the show "ER" replaced with "PT" and people rushing about doing exercises,ultrasounds, and screaming "we need an OA release on table 4 STAT!"...it is a joke, lighten up.
I absolutely miss some of the mellow days in PT, and I think the experience I learned was fantastic in many respects. It was a fantastic foundation to build upon, especially for a DO medical school. While my PT days are behind me and I focus on more medical issues primarily in acute medicine (I guess I live the ER lifestyle), my orthopedic experience has become very helpful in sports medicine and allows for me to relax (relatively speaking).
So Augustine, I am not sure why you are so defensive. Eval and treat is often times a compliment and the broad diagnosis is more a billing issue than anything else. Who cares really? Have you ever sat down to validate all of your own diagnoses? Can you even validate your testing or treatments in PT? Does it really matter? In the big picture of the referring physician seeing and controlling chronic disease, does it REALLY matter you got a nice fluffy easily billed script for cervical strain? Would you prefer a segmental diagnosis? ...perhaps you will be grumpy regardless.
As for reimbursements, your fight is with massage therapists, trainers, personal trainers, muscle therapists, healers and the like...NOT with doctors. The local PT has a huge battle to fight and it ain't with me...so perhaps you should choose your battles better. I will always refer to PT, but many are going elsewhere.
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Dr. Wagner DO
Moderator of Medical Complexity Forum
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Re: thinking about med school after PT school - November 14, 2004 12:16:00 PM
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Augustine5I
Posts: 28
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From: NJ
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Dr Wagner,
Sorry if I missed the punch line. I actually have quite a sense of humor, so for me to miss the "joke" is rather unusual.
Truth be told, I really am not that hung up on a specific diagnosis. But if I must except a prescription from a physician prior to treatment, then he/she should do their job and perform a proper assessment. It would aways be helpful to have as much information as is possible prior to the initial evaluation.
I can't tell you how many times a client will return from a physician re-check only to tell me that he/she "didn't do anything". That after a 1 to 2 hour wait, they merely talked for 5 minutes. Patients find this quite disturbing.
Unfortunately, we all face encroachment. Professionally fighting for the same reimbursement dollar.
Recently the receptionist where I used to work went to a massage therapy school for nine months. Part of the curriculum was "medical" massage. I actually looked over the material she was studying as part of the class work. It included things like "treatment for tennis elbow" and the like. This is a problem, and not just for physical therapists. Massage therapists will and are looking to circumvent the system. They are held to no standards that I know of.........
I accept the APTA's 2020 vision. And I think we are making progress. I am a spoke on a wheel, like everyone else.
Respectfully,
Tom
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[URL=http://www.colonialpt.com]www.colonialpt.com[/URL]
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Re: thinking about med school after PT school - November 14, 2004 1:27:00 PM
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Dr.Wagner
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From: Indianapolis
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I am glad that is straightened out...but I often wonder about the future of PT. It is such a great profession but the APTA has done soooo much to make it difficult for new grads to prosper. In a time with decreasing reimbursements, more encroachment than ever, and the highest tuition I have ever seen with virtually no change in base pay (hell I owed 5k and made 41k 10years ago)...I feel bad for the new grads. But those same issues will never be a problem for the current APTA board, since they probably didn't owe more than 20k in loans between them, and making decisions for other people is pretty easy especially those with "visions". Yeah, they have "visions' all right;)
Anyway, I always thought the "PT" analogy to "ER" was kind of funny.
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Dr. Wagner DO
Moderator of Medical Complexity Forum
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Re: thinking about med school after PT school - November 18, 2004 3:01:00 PM
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Augustine5I
Posts: 28
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From: NJ
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Dr. Wagner,
Unfortunately, it is nearly impossible to support a family on the salary a staff physical therapist makes these days(depending on where you live).
If it were not for pure greed..........more money would be spent paying those individuals responsible for each dollar reimburesed.
Those therapist graduating with a Doctorate degree will not see any difference is their pay scale so long as reimbursements remain the same. After all, all things being equal (as far as reimbursements go), there is no need to pay more.
Still, a busy office can make quite a bit of revenue if the referrals are there. Even at two an hour, a lot of money can be made. Point being, therapists should demand more.
Maybe they should make a show entitled "PT". Could be pretty funny depending on the types of characters. Plus thos F.O.S. (Full Of Sh##T) patients.
Peace to you and your home,
Tom
_____________________________
[URL=http://www.colonialpt.com]www.colonialpt.com[/URL]
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Re: thinking about med school after PT school - November 18, 2004 5:07:00 PM
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wjPT
Posts: 33
Joined: October 11, 2004
From: San Diego, CA
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Augustine,
I have choosen to pursue the world of medicine because I want to be involved in the provision of surgical care to patients as indicated. It may be as an ortho doc, a plastic surgeon or even a general surgeon, so I may or may not use the services of physical therapy.
If I do become an ortho doc, I will be sure to provide an appropriate and specific Dx for the patients referred to PT services, as I dislike the common "Lumbar strain, eval and treat" just as much as you appear to.
I enjoy the field of physical therapy and I feel that my experience working with a variety of patients as a therapists will be an invaluable experience. I plan on working for at least 2 years as a PT, so my skills developed in that time frame should benefit me in the future.
Warren
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