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  1. I finished PA school recently and started working in emerg (as part of the psych team) and cardiology. I work and manage a bunch of R1-R5s at various stages of their residency and all of them talk about debt, the CaRMS process being flawed and the ?subpar pay post-residency. I'm having a bit of trouble understanding where they're coming from, since conversations with attendings and RNs reveal they're being paid pretty well. For example, emerg docs are the highest billing at the hospital I'm at (500k+), psychiatrists are making 360k+ with no overhead, cardiologists are making 400k+, hospital internists are making 250k+, etc. Even with the debt, wouldn't these annual salaries trump ~125k debt pretty quickly? Residents always talk about my pay being great for the time I've been spending and education (6 figures for M-F 7.5 hrs, no overnight call + benefits/pension). I understand some specialties have overhead but none of the above specialties would have significant overhead (minimal to nil). I've even read people on this forum post fam medicine salaries around 250k+ for not too extravagant hours. Even after taxes, most specialties are pulling in 180-200k+ net income. That's ~15-17k/month in net income to do whatever you want, which is awesome imo! But am i missing something about the numbers here? Paying for benefits, setting aside money for retirement shouldn't take a bulk of your take home net pay and you'd still have a substantial net home pay. Basically, I'm wondering if it's worth heading to med school and try to up my salary to those levels. I've rotated through 90% of the med school core rotations and taken 3 electives so I have a good grasp of how clerkship works and residency, giving me an advantage. I've written the MCAT 4 years ago and my score is competitive for my in province school. I don't even mind spending ~125k to get the MD to easily pay it off after residency. I would end up applying for family medicine only given the length of other residencies at my point in life. What would others do in my position? Thanks!
  2. Current PA-S2 here, I can echo the sentiment provided by the people here. The nursing union is really preventing the use of PAs in Ontario and its concerning that the government doesn't recognize the work of PAs even during the pandemic. There have been issues with funding but most people are doing okay in their respective positions. Not sure how long it'll last though, since most of the people in ER/ICU are employed but fam med and subspecialties are seeing drawbacks (endocrinology PAs have been let go where I was on placement, possible other specialties too but not sure about others). Its not necessarily stable but not unstable either if that makes sense? Funding gets pulled quite easily and its difficult to get funding in new hospital areas. The biggest challenge is explaining your role in the healthcare system and why PAs are necessary to help reduce wait times and improve efficiency. The PAs I've worked with state that there are occasions where nurses, NPs, physicians question the role of PAs and see them as a threat to their income/jobs. It's going to be over a decade since PAs last tried to be regulated in 2022 so the fact that we're still discussing this is concerning for the profession. The work we do is exceptional and we have life experiences prior to entering this field, as well as on the job training that prepares us to handle a variety of situations independently, as well as part of the healthcare team alongside physicians. South of the border, it's quite different and I wish we could adopt the US model here to have the maximal impact of PAs in the healthcare system. For those still looking to go into the profession, make an informed decision and know the field is great if you have employment but its not something thats remotely stable compared to MDs.
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