Career change to Surgeon at 46 - possible??
November 5, 2010 4:10 PM   Subscribe

Can I do something in medicine (esp. surgery) I am 46 and missed my calling... what about being a surgical Physicians Assistant (PA) what's the schooling requirements? what are the earning prospects?
posted by Barrows to Education (16 answers total) 14 users marked this as a favorite
 
This Askme from yesterday might be helpful.

As far as your age: I have 3 friends who have done midlife career changes into medicine (RN). All were over 45, one started at 51.
posted by jamaro at 4:36 PM on November 5, 2010


Oh man, my dad basically did this. Was a pharmacist for forever, then decided to run off to med school.

For a PA program, there was a question a few days ago that might prove useful. To become a Real Libe Doctor, look into med school down in the Caribbean. They have lower standards for acceptance down there, which mostly caters to kids who did poorly in school but can also prove useful to older students.

All in all, though, I say go for PA. School for doctorhood is going to take forever (most every older student in my dad's class has given up a year or two in), and surgery, I think, is best taken up when you're young, so your experience can counter any of the detriments of aging.
posted by soma lkzx at 4:44 PM on November 5, 2010


American Academy of Physician Assistants - there seems to be a lot of useful info on their site.
posted by purlgurly at 4:48 PM on November 5, 2010


You might consider looking into a postbaccalaureate premedical program and then going to medical school, if that's your goal. My doctor took this route and it obviously worked out for him.
posted by easy, lucky, free at 4:53 PM on November 5, 2010


When I was in my late twenties and had dicked around so much it seemed like I would never get a BA, I saw (I swear to God) an Ann Landers column where someone was saying something like, 'If I went back to school now, I'd be X in four years when I graduated' and 'Ann' said something like, "well, you're going to be X in four years anyway."

Just something to think about. From ol' Ann Landers. Ultimately I wound up with an MFA somewhere in my thirties. FWIW.

Time's going to march on regardless.
posted by A Terrible Llama at 4:54 PM on November 5, 2010 [18 favorites]


It’s definitely possible. I’ve seen medical students in their forties at my school. If you want to be a surgeon, you are faced with at least 10 years of mentally and physically grueling training (4 years of med school + 6 years of residency) and accumulating along the way educational debt well into six figures. If this seems too daunting a commitment and you find yourself still wanting to scratch that surgery itch, you can definitely consider becoming a physician assistant, as others mentioned above. The training is much shorter and the pay is quite decent.
If you'd like to explore this career path, I'd encourage you to do some volunteering in the hospitals if you haven't already. Contact any physicians you know and see if you can set up some shadowing with them or refer you to surgeons who'd let you observe in the OR. Failing that, I'd try to contact the pre-health advising offices of your local colleges and see if they have any programs for students. Getting some exposure to the hospitals is important both for your own experience and later application process.
posted by Pantalaimon at 5:43 PM on November 5, 2010


I'm a doctor, and I would really, really advise you to spend some time talking to surgeons before you get too far into this. Surgery is a very punishing field, both mentally and (especially) physically, and it's honestly not something I would want to train for in my late thirties, much less my fifties. If you go the MD (or DO) route, it will first be at least two years of prerequisite undergraduate classes before you apply. Even if you took all of the science classes when you were in college, med schools generally insist that they be recent (usually within five years). After that, it will be four years of medical school, then a minimum of five years residency to become a surgeon. Residency is tough. You will work about 100 hours a week (there are 80-hour work week restrictions, but they are almost universally a joke, particularly in surgery), often working all night on your feet. It is rigidly hierarchical, so you will be expected to take a lot of shit from people who might be twenty-five years younger than you are. For all of this hard work, you will make about 40K a year for the residency years, but you will have between 100K and 200K educational debt.

So you're looking at being about 57 when you're actually an independently practicing surgeon. Yes, you'll be 57 then anyway, but you could be 57 without a couple hundred grand in educational debt and a stress disorder.

I'm sorry to be discouraging. I'm a career-change doctor myself, although I was much younger than you when I made the switch. I love my work, but it's got a lot of tradeoffs.

PA school is more doable. You will still have to spend about two years getting the prerequisite classes, but PA school is 2.5 years instead of 4, and there's no requirement to do a residency. They have much more flexible schedules, and the earning potential is good -- high five figures in my market.

Good luck...hope you find something you love.
posted by LittleMissCranky at 5:43 PM on November 5, 2010 [8 favorites]


It's not impossible at your age to be accepted to medical school. I have first-year classmates who are in their mid-thirties, and I think that my school admitted a 40-something last year. If you want to become a surgeon, the postbacc is probably your first stop. If you want to be a PA or a OR Nurse then your first stop might be to get a CNA or EMT/Paramedic cert to get some clinical experience, then onto an RN or PA school. There are a number of paramedic-to-PA bridge programs that I've heard about, and there are a lot of one-year RN progams, too.

I'll say only this about medical school: if your vocation is only to be involved in patient care, do not become a physician/surgeon. Assuming you do a one-year postbacc before you take the MCAT, you're looking at three years of hardcore book larnin' before they even let you near the patients. If you're not good with seeing the light at the end of the tunnel, you'll find yourself working through your Organic Chemistry homework and wondering what the hell you did to deserve it. This is all to say that you should be just as committed to study as you are to patient care-- you'll be doing almost a decade of it.
posted by The White Hat at 5:52 PM on November 5, 2010 [1 favorite]


PA is a great option for you. You will have some pre-requisites to do first before you apply and most PA programs require some sort of prior medical experience (i.e. nurse, tech, MA...). But it certainly is doable. Still, you are looking at probably at least a year to get the pre-req's and some medical experience (some places also like volunteer experiences as well and will want to see you have shadowed/worked with a PA) and then at least two years for actual PA school.

There are a couple of surgical PA programs but you don't need to go to one of those to be a surgical PA. You can choose to do a 1-year residency in general surgery or orthopedic surgery after you graduate but even that is not necessary to become a surgical PA.

The earning prospects are good. Look at salary.com for your specific area as it varies from state to state. Also how marketable being a PA is (vs. being an NP) depends on the state you are in.

Another option you may want to look into would be a surgical tech. I've been in plenty of ORs (especially in ortho) where the surgery tech knows a tremendous amount about the procedures for which they assist.

Or you could become an NP, which is also a good option. I believe there are some programs out there that have a combined BSN/NP track.

Good luck.
posted by teamnap at 5:53 PM on November 5, 2010


I can't remember if it was JAMA or NEJM, but there was a recent study that pegged sixty as the top-out age for surgeons, simply based on the average amount of age-related changes. Not for practicing medicine, but performing as lead surgeon. So..if you're especially lucky, you might get a few more years past sixty before it seriously hampers you, but with so many other fields in medicine and allied professions, I would advise against pursuing surgery as the end goal.

Also, from a surgeon's daughter, your first years in practice are hell on family life. It doesn't matter how devoted and loving you are....it's hell because you're run ragged and nobody sees each other. This? Sucks for everyone.
posted by Uniformitarianism Now! at 6:09 PM on November 5, 2010


My Dad is 60 years old and taking the prereqs for PA school, totally having a blast. Absolutely doable for you too.
posted by rockindata at 6:50 PM on November 5, 2010 [1 favorite]


While you're researching, consider advanced practice nursing (NP). There are graduate-entry programs (you can apply with a bachelor's degree and your pre-requisites) with acute care speciality. Acute care NPs work within a broad range of hospital practice and with surgical groups. I observed an APN perform independently, for example, a cardiac valve replacement in a pediatric cath lab at a major Children's hospital recently--one of the first give times that procedure had been done. Another specialty in Advanced Practice Nursing is Certified Nurse Anesthetist which would put you in the OR suite everyday and has terrific earning potential (more than PA surgical techs).

The thread linked to in this thread briefly mentioned NPs, with some of the misconceptions about the field that I hear all the time. It's true that there are states that don't allow NPs to practice to the full extent of our education, but the Health Care Reform bill actually eradicated, or paved the way to eradicate, many of these issues and even the most restrictive states have dozens of house bills eliminating barriers to practice. And, even in the most restrictive states, the work is fascinating, broad, challenging, and independent. Restrictions are a result of legislative bodies, and the power and commitment of physicians' lobbies (nursing organizations are only recently snapping out of their political naivete) not the education itself.

So, I do encourage research into the field and modes of delivery. Once of the misconceptions about NPs, for example, is that they are physician extenders, when in fact, they are independent practitioners within the nursing model of healthcare (vs. the medical model of healthcare). This distinction is important, as it reveals a different methodology--NPs are equal collaborators with a unique delivery of care. Consider shadowing NPs in the hospital setting to get an idea of what it is they do. Also, as an older student and practitioner in the field, there are, literally, countless opportunities to modify your career into retirement--well funded research, teaching faculty (there are provisions for this in Health Care Reform, as well), and administration of various stripes.

The education is rigorous as graduate-entry. A year of pre-reqs similar to a post-bacc, and then 3-4 years of little sleep and constant study. From there, if you are interested in acute roles or nurse anesthetist, there could be 1-2 years of additional study and clinicals. However, you will save time over medical school, as well as money. What's more, there are many, many generous loan forgiveness programs in the profession of nursing--both state and national. Also, there are many scholarship programs for all levels. I have one year left to being a PNP (Pediatric Nurse Practitioner), I'm going to a huge, ranked and fancy program, and I won't owe a dime upon graduation due to scholarships and assistantships available to me in this field. This is true for most of my cohort.

This is much longer and more persuasion-based than what I meant to write, but I do think there is misunderstanding about the profession, roles, and opportunities here. I think that it would be prudent to do some careful research and do some shadowing and volunteering. Changes to health care and its delivery system are constant right now, which means there is lots of opportunity (as well as confusion). Talk to doctors, nurses, PAs, APNs, and their advisors in those colleges. Try to ignore well-meaning but non-expert advice (you REALLY want to get your advice from people in it when making this decision. Healthcare is its own culture).

FWIW, there is a late fifties man in my cohort, who will graduate next year as a Neonatal Nurse Practitioner (and will work as a practitioner in a level one NICU managing a large caseload of neonates, performing lumbar punctures, ordering imaging and drugs and care, as well as performing other complex procedures and assessments), and he folds right in. Patients trust him quickly, and he brings his entire work and life experience with him into the work. Such a thing is most welcome.

Good luck.
posted by rumposinc at 7:31 PM on November 5, 2010 [3 favorites]


No matter what degree you pursue, please consider researching the employment prospects in your career choice. Basically, you need to find out what the market is like for new grads in your field. There are way too many second career new RNs with a high debt load who as new grads and can't find full time employment right now because the market is a little saturated in parts on the US right now.

That's not to hard to do. First you can look at a hospital's employment site and just see if there are positions posted. Second, you can go to a professional association meeting for NPs or PAs, etc., meet some folks and and get a sense from them about the market in your area. Third, you can shadow some folks and find out about job prospects in that facility. Lastly, you can research what kind of career support is offered from different schools you are considering applying to. And the answer really ought to be something other than, "Our grads just get jobs."

Good luck!
posted by anitanita at 8:56 PM on November 5, 2010 [1 favorite]


If you like surgery, but don't want to take 10+ years to get there, how about some like a pathologist assistant program? Admittedly, you'd have to be comfortable about not curing/healing people, but it can be great fun.
posted by greatgefilte at 2:17 AM on November 6, 2010


If you specifically want to be involved in surgical cases, why not become a surgical technologist (AKA scrub tech)?

Even though you're not the surgeon, you're scrubbed in and are an intimate, irreplaceable part of the surgical team, setting up the OR and ensuring asepsis and passing instruments and retracting and clipping sutures, etc. You're in the visceral thick of it, sometimes literally up to your elbows in someone's belly. You can get there with an associate degree (the preferred education level for entry to practice) or other certificate program and save yourself years and years of grueling MD training that I wouldn't wish on my worst enemy.

A good, trustworthy scrub tech is a surgeon's best friend, and if you're good at what you do, you'll see some really incredible cases. Lots of surgeons request specific scrub techs by name for their cases, and the relationship between tech and surgeon can become a professional partnership that's really rewarding.

The only bad part is that you don't get paid very much, so if you're looking for tons of cash, this wouldn't be the route for you. But in your specific case, I think it's probably the best way to get yourself to the table as soon as possible.
posted by jesourie at 12:51 PM on November 6, 2010 [1 favorite]


jesourie beat me to it. you can get a surgical tech certificate for very little time/money (compared to med/ PA school anyway) and at least it would be an opportunity to check out the field up close and personal. i don't know what your background is or if you've spent time in an OR before but you gotta do that before you can really decide about committing a lot of time to a more advanced degree in the field. surgery is like its own universe and i think people generally love it or hate it. (when i suddenly decided a few years ago that surgery must be my "calling" i took a crap job cleaning ORs just so i could check out the scene and be sure. it was probably the single most important thing i could have done before deciding to attend medical school, because i got to see what things were really like, not just the great way i was imagining it in my head.) but surgical tech, honestly, is a pretty cool job. i mean you are right there next to the surgeon, you get to see everything. you just don't make very much money, unfortunately. you could probably make more money being an OR nurse. i don't know too much about nursing, but i know you have a lot of options as far as education level (2 year, 4 year, masters) and that they make a pretty decent living. i don't know how much the education level makes a difference in your earning potential. good luck, though, whatever you decide!
posted by lblair at 5:25 PM on November 7, 2010


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