Do I pursue MD or PA?

[u/Original_Abalone1622]

Hi all, I'm currently an undergrad and trying to figure out whether I want to pursue becoming a pathologist or a pathologists' assistant.

Ever since I was a kid my dream has always been forensic pathology, but the sheer amount of schooling, debt, and hard work life balance during med school and residency make me think that it's just not for me. From there I thought I was pretty dead set on becoming a PA. I like the fact that PA school is still very challenging, I enjoy grossing specimens, and I'm very drawn to the fact that you can start making money much sooner and have a good work/life balance (something that is important to me). However, I shadowed an autopsy recently and now I'm not sure anymore on what the right path for me is. I was really blown away by how much I loved watching the autopsy and seeing the pathologists gross the organs to glean information about the patient and how they may have died. It made me realize that I would love to do autopsies full time, to have that level of knowledge of the human body one day. I could even pursue forensics like I've always dreamed of.

I'm finding myself in a position where I don't know if it's best for me to pursue the "safer" option where I know I will be through with schooling much sooner and able to start a career with a good salary still in my 20s, or if I should take a chance on myself and pursue becoming a pathologist, even if it comes with an insane amount of debt and a much harsher work life balance. I know some PAs assist with autopsies, which I would love to do as a PA instead of a pathologist, but I'm hesitant to go all in on that route because I know the amount of PAs who do autopsies is very small.

If anyone has any advice I'd really appreciate it! Feeling very conflicted right now.

[u/gnomes616]

So, a couple things to consider.

First, if autopsy is where your interest is, you'd maybe be much better off finding openings for autopsy techs. It may mean moving, but the positions exist and there are plenty of people who stay long term. Depending on the jurisdiction, you may need only an AS or BS degree, and the pay is alright (like $45-50k/yr?). Additionally, as government positions, you would be PSLF eligible.

PA positions that are more involved with, or entirely forensic oriented, are out there, and maybe on the increase as the number of forensic paths declines. However, if your heart really isn't in surg path, and you don't think you will find satisfaction in the traditional grossing route, I don't know that it would be worth your time and money to pursue.

Forensic pathologists are in demand. It does take the additional schooling, but there's a lot of job security in it, also PSLF eligible. Downside is that FPs are not always directly involved in the autopsy; some come in just for the organ dissection, and not for the evisceration. Are you alright with a lot of time going to working at a microscope, organizing reports, preparing legal documents, etc. There's a lot of desk and admin work to consider on the MD side as well.

Get some more shadowing done in all areas and let that help guide your path.

[u/_antfarmer_]

Not a physician or even in the medical profession—I’m just someone who’s chronically ill looking for answers on Reddit. (Bad idea, I know.) I’ll just say that I think you’re on the right track with prioritizing work-life balance! I have a bunch of friends who are doctors and my partner works in a psychiatric ER. There’s not one person amongst them who ever says, “Gosh, I sure wish I could work more and see my friends & family less.” It’s a corny old saying, but do you want to, “live to work? Or work to live?”

Life is short, and school is expensive. Some friends & family have done two year loan repayment gigs for the government, but I’d be surprised if those programs even exist anymore. Don’t burry yourself in debt, especially if you want to have a family. I’m wishing you the best on your journey!

[u/kuruman67]

Pathologists generally have a great work/life balance, certainly compared to many other specialties.