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The Premed Years

63: PA to DO – What Route Should YOU Take and Questions to Ask

Broadcast on:
05 Feb 2014
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In today’s episode, Ryan talks with Dr. Mark Kauffman, the Assistant Dean of Graduate Studies at Lake Erie College of Osteopathic Medicine (LECOM), who was previously a PA.

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MappedCon presented by Blueprint Test Prep 2024 is this Friday, October 26, 925 Eastern. I'm starting the day in my track, the pre-med track, planting the seed of your personal statement. We have three tracks going all day long and a couple hours of amazing exhibitors where you can learn more about their programs. Again, MappedCon presented by Blueprint Test Prep, October 26, register for free. It's a virtual event and all the sessions will be up after. So even if you can't make it live, go register and get access to the sessions. Go to MappedCon.com right now, register. That's M-A-P-P-D-C-O-N.com. If you're applying to medical school in 2022 to start medical school in 2023, join me Wednesday or Thursday, Wednesday night at 9.30 p.m. Eastern or Thursday at 11 a.m. Eastern at premedworkshop.com. Go register today. I'm going to show you how to tell your story in your application. Again, that's premedworkshop.com. If you are applying to medical school in 2022, be there or be square. The Medical School HQ Podcast, session number 63. Hey, this is Z-Dog MD, rapper, physician, legendary turntable health revolutionary and part-time gardener. And you're listening to the Medical School HQ podcast hosted by the irredeemably awesome Ryan Gray. Welcome back to the Medical School HQ podcast. Now, whether you are premed, lost in your journey or medical student discouraged on your path, we're here to help encourage, motivate and enlighten you about why you're choosing to join one of the best professions in the whole entire world. We're here to guide you on your path to becoming a physician. Now, as Z-Dog MD introduced me, I am Ryan Gray, your host, as always, for today's podcast. Today, I have an interesting guest, and I'll get to him in a minute. First, I want to thank the four people that left us amazing five-star reviews, and there were even more ratings. We're up to 134 five-star ratings, which is awesome and worldwide. That's amazing. 131 from the United States. Two from Canada. Hear this. One from Saudi Arabia. So, from the Yemeni medical student from Saudi Arabia, awesome. Thanks for leaving a review. So, we had Alex Designs who said he referred this podcast to friends and families. Thank you, Alex Designs. Doug Recycler says a gift for all premeds. Awesome. And Mark CS, great for an entering medical school student. So, Mark CS got into medical school. He's starting at looks like this year, which is awesome. Congrats to Mark. Thank you for leaving a review. And hopefully, the information while you're in medical school, the information that we provide here, while more geared towards premeds. Hopefully, there's information for the medical students out there as well. And Mark, while you're going through this process, let us know. What do you want to hear? And that goes for all the medical students that are listening. Let us know what kind of information you want tailored for the medical student, because even premeds need to hear that stuff as well. And as you know, these podcasts are living on forever in the interwebs. So, they're good for everybody. And then, as I stated earlier, the Yemeni medical student from Saudi Arabia says, thank you for your great efforts. So, thank you from Saudi Arabia. That's awesome. If you haven't left a five-star rating or review or any star rating or review, medicalschoolhq.net/itunes. We appreciate everybody that goes and takes two minutes to do that, because that shows iTunes that this program is worth showing to other people out there looking in iTunes for a good podcast about medical school and the whole premed journey. So, thank you if you've taken the time to do that. And if you haven't, it's about two minutes. So, we appreciate everything you do. Let me introduce today's guest. He is Dr. Mark Kaufman. And I forget where I stumbled across his story. But what resonated with me and what I wanted to talk to him about was the fact that he used to be a PA. And so, I wanted to discuss for all those students out there struggling with that decision, should I be a doctor, go to medical school, give up four years of my life, and at least three years of residency, and all of the debt that comes with it, that's the big argument versus a couple years of being a PA and out in the workforce with a lot less debt. So, that's what I wanted to talk to him today about, because he made that leap from being a PA to going to medical school and is now working at Lake Erie College of osteopathic medicine, where they have an awesome program for PAs, current PAs that want to go back into medical school. It's a three year program. It's pretty sweet. So, we talk all about that in the interview. We're also going to talk about whether he practices medicine differently, what he would tell a pre-med student right now struggling with those decisions on whether to be a PA or to be a doctor, and a lot of great general advice for everybody. So, take a listen and I'll catch you on the flip side. We start off by talking about his initial path into medicine. Okay, well, the decision to go into medicine was lifelong. It was never wanted to be anything else except a physician. My father always commented that he had never seen a kid say that they plan to be a doctor and continue to do that. I think it was cemented. That little story is that a friend of mine, we found a dead toad in a window well. All that was left was the bones. And the next day, I came back with the skeleton put back together to him to show him the skeleton. So, I think that's what I meant to be and that's all I would ever be. Awesome. And so, you started off on a path of knowing you wanted to be a physician, but you didn't go that route. Right, so where I came from, you know, there was a few people that went to college. My own family, there was only one other member that ever went to college. So, honestly, there was some self-doubt there. I thought you had to be a genius to go to medical school. And my fear was that I would go into pre-med, do biology or chemistry and then not get into medical school and have to maybe teach those things, which the funny thing is now I'm actually a teacher at a medical school. So, I've come full circle. I think that's actually my true specialty as teaching, but that's not what I wanted to do. I didn't want to teach biology or chemistry. I wanted to be a physician. So, my father actually was in a military. He's a career man and he's the one that found the PA profession to me. And he came and said, "Look, here's this profession that you can still be in medicine. You're not a physician, but you're certainly practicing medicine." And what was interesting to me about it was that if I went through and graduated, then I could still be in medicine, what I loved and wanted to do and still provide for a family. But if I wanted to go further forward, then I would have the opportunity to do that later. So, it sounds like initially you had that thought in the back of your head that even if I go the PA route now, I can always do more later. Exactly. And it probably wasn't the first day of PA class. They put us in those small groups and they said, "So, what do you plan to do?" And I said, "Well, I'm going to be a PA for a couple of years and I'm going to go to medical school." I guess that was a wrong answer. I didn't realize that it wasn't not looked upon as a stepping stone, and it is a wonderful profession in itself. But I had the desire to go further with it. So, can you talk about that for a minute? If you knew that that desire was there, why not just go that route in the first place into medical school? Well, I think it was again that self-down. I didn't think I was going to be good enough to get in. The competition is high at 40 to 1. Getting in. So, I was concerned that I would do pre-med and not be able to get into medical school. So, you were using the PA route almost as your fallback, and you could apply later, and if you didn't get in, oh, well, you were still a PA? I wouldn't really call it a fallback. It was what I loved to do was practice medicine or one to be in medicine. So, that was my assurance that I could be in the field that I wanted to be in. And if I never went forward, that would be fine. But at least I was in the practice of medicine. Okay. Very interesting. So, you get out, you went to PA school, and for those listening, how long was PA school? I was in a four-year program that was included in the bachelor's, but we went through the summers, too. So, it was considered basically the credits of a five-year program. And that was before the master's degree became the terminal degree. Okay. And then, you get out and start working as a PA. And how long did you do that? I worked for six years. I did pediatric transplant surgery at Children's Hospital in Pittsburgh. Wow. That sounds awesome. It was. It was incredible. So, at what point along the way did you go and why did you go? Okay. Now it's time. Yeah. It was very satisfying. The position that I was in at Children's was that fellows came in from all over the world to be trained in transplant surgery. So, we were on the cutting edge of medicine. We were doing small bowel transplants. I was involved in the first 30 pediatric small bowel transplants that were done in the country. But I always had that desire to be the one who accepted the challenges that came and some of the disappointments that came. And I wanted to fully accept them, but also be recognized for the services that I was providing. So, it's maybe a poor example, but I'd spend on a transplant patient who was on hyper-elementation, spend an hour working up a very critical hyper-elementation. And the attending would come along and in two seconds take out a different piece of paper and fill it out and sit there. Spent too much time on this. So, I wanted to make those decisions. Okay. And so, you started looking into going to medical school. Now, what kind of feedback were you getting at that point? You've been a PA now for six years, and now all of a sudden you want to make the leap to medical school. What kind of feedback were you getting from people? Well, I think I had a lot of support, actually. I was pretty autonomous within our practice. I was helping to train the fellows that came in from all over the world. So, I think nobody was surprised that I wanted to take that next step. And I think I got a lot of support. I didn't have anybody actually saying, "Don't do it. It wasn't worth it." Okay. And what about after you've submitted your applications on your interview trail? What kind of questions came up about that switch? Actually, the only questions that really came up were my past clinical experience. They wanted to see what I'd already done in medicine. And then, they were more interested in what I thought I would bring from my PA education into my education as a physician. They wanted to know if what the training, they wanted to compare the curriculums a little bit to see what kind of experience I already had and what I'd be able to do. Interesting. How did you find the application process and the interview process? Was that stressful for you? Or did you kind of find that easy knowing that you were already a PA? And again, I know you said you didn't use the PA as a fallback plan, but versus an undergrad pre-med student that has their whole career on the line, you had a career already. Yeah, you know, it was still it was still intimidating. Again, I had that perception that you had to be a genius to get into medical school. So it was intimidating. It was an interesting development. There was a new medical school that was opening or had just opened. It was in the third year of practice up in Northwest Pennsylvania. It was called Lake Erie College of Osteopathic Medicine. So it was a rather new school. And it was the closest to where I was practicing in Pittsburgh with my wife being from Cleveland. So purely by geography and looking at their program, I wanted to see if that would be a good match for me. I had osteopathic physicians as primary care physicians. So I was actually more in line with osteopathic philosophy in medicine. So an osteopathic school was what I was looking for. So the way I actually arranged my interviews is that I contacted the school and I asked them if how soon you found out after you were there, if you got accepted, and they told me two weeks. So geography-wise, what I did was I scheduled about five or six interviews for later, then about a month after my first interview, went up to interview at Lake Erie College of Osteopathic Medicine. And sure enough, within about two weeks, I had my acceptance. So I just canceled all my other interviews. That's nice. Makes it easy. Yeah, cheaper or much cheaper. I had flights, you know, how to get flights gone, things like that. But as soon as I got that, notice I was done. Very good. That's awesome. And so you went to PA school. Now, I'm sure there's going to be PA's listening to this, wondering if they should make that leap too. What was med school like compared to going through PA school? It's really a good experience that I've had that I could compare the curriculum between the two schools. So as physician assistants were trained to take the history, perform the physical examination, come up with a diagnosis and know how to treat that diagnosis. What's really missing or not missing, but not as much depth as given to it is the pathophysiology that goes behind it. So that's what actually the curriculum, the basic science curriculum within the medical school is much more rigorous. When you talk about the detail of anatomy, the pathophysiology, the micro embryology, these go into much deeper levels of information than I experienced in PA school. Okay. Now that you're out practicing as a D.O. as a physician, can you compare practicing as a PA versus practicing as a physician? Well, you do have that full autonomy. You know, our bosses are the patients, of course, they're the patients for mid-level practitioners too, but there is always somebody that you have a relationship with as a PA where you have a supervising physician, which is, you know, a nice thing to be able to have. And the lifestyle that can come with that, I mean, certain PA careers mean that you're extremely autonomous and you're working hard hours and long hours and you're not done at the end of the day, you're on call, so that is very consistent with some of the physician practices. But at the end of the day, somebody still has supervisory responsibility for you. When as you're a physician, it is your responsibility. And that's one of the things that's, again, a benefit and also a challenge is that you are fully responsible. You accept the successes when you have successes, but you also have to accept when you aren't as successful as you'd like to be. When a pre-med student is in their first or second year of undergrad or third year and they're deciding if they want to make the time commitment to go to medical school or the financial commitment or go to PA school, what kind of questions can they ask themselves to try to determine what's best for them? There's a lot of opportunity in the PA profession to have the differing level of autonomy that you want. And some PA's have actually gone together and started practice or even individually started practice, and then actually hire a physician to come in and do that role. Yeah, that's a curd, actually. One of my friends that I graduated from PA school has done that. So he is completely autonomous with a physician coming in and doing the political requirement or the requirements for having the co-signatures and the prescriptive rights, that linkage that's required. So if you are looking at a profession and you don't want to have the expense of medical school, you do want to have less commitment. A lot of PA jobs are over at the end of the day, where when you go home, you're not on call and the attendings on call or the physicians are on call and you work your straight hours. So if that's the kind of lifestyle that you're looking for, then that's a perfect match because the responsibility is a little more flexible so that you can have that end of your day a lot more often than a lot of physicians that I do. What are some of the specialty limitations, if any, that a PA might be able to do versus a physician? Actually, with the scope of practice of physician assistants, physician assistants, it is that you can do anything under the scope of your practicing physician. So if your physician is a neurosurgeon and they take you to the OR and you're first assisting on the neurosurgery cases, then that's what you're allowed to do. So that written agreement is the key to what profession or what specialty you're going to go into. So really, there's a lot of clinical experience that you get when you first start that job. You come out from PA school, you've experienced the clinical rotations for a year so you have some idea, but you really start your training. Your residency is actually like a working training. Of course, they have PA residencies for certain things like surgery, PA residencies, orthopedic surgery, residencies. But most PA's experience the same thing as a residency when they're actually working in whatever service they're on at the time. So you get people that are experts in the emergency room and people who are experts in primary care. So that's where you get the experience. Okay, so really, there is no limitation. If you want to be a neurosurgeon PA, like you said, you can be a neurosurgeon PA and be in the operating room and be cutting on a patient just as you would as a physician. That's right, under the scope of that practicing physician. If they think you're competent and they give you that written agreement that says you're capable of doing this and these are your responsibilities, that's what you do. Yeah, and I've seen it in my own training going through a lot of orthopedic training, which is what I initially wanted to do before the Air Force said, no, we're going to have you do this instead. They were a lot of surgical PA's, orthopedic surgical PA's that would be alone in the OR because the attending was in the room next door and was comfortable with the PA either closing up or opening or doing whatever with that patient. Exactly. That's awesome. So the program at Lake Erie College of Osteopathic Medicine, you guys have a special program there for PA's. Right. So going back to when I decided to go to medical school or started after the six years of clinical practice looking back into going to medical school, there had always been a rumor about programs, medical school programs out there that offered some sort of advanced standing or accelerated program and that's actually what they were. They were all rumors. They, the night really existed. So you'd call a place and they'd say, yeah, we've heard about that. Every couple of years there's a cycle through and they call us and ask us about them. We don't have one. So part of my transitioning career was to go back to my medical school and become faculty member and teacher, develop a history and physical examination curriculum. So that's where I went back and saying, okay, this is really my profession is teaching people to be physicians. And to learn more about that, I decided to take a master's in medical education course, which really gave me the basis of why you teach the way you teach and why I would get rid of things that didn't work and why I would stick with the things that did work. And now I understood the processes behind that. And part of that curriculum was a thesis in developing curriculums. So I thought, well, let's bring my two knowledge bases together, my knowledge of the PA curriculum and my knowledge of the medical school curriculum and to do my thesis on that. And what I proposed was that rumored three year accelerated pathway where physician assistants would get their DO degrees in three years instead of four. And originally, I thought that I would accelerate the didactic curriculum. What I did to develop that program is I went back and found 12 physician assistants who had gone through LECOM earlier and saw what they performed on their board performance. And this brings us into the topic of MCATs. So in PA curriculum, only about 50% of the colleges require organic chemistry. And only 7% of colleges require physics for PA programs. So PA is when they're deciding to go back to medical school or at a disadvantage, because when they oftentimes decide to go back, they've been working for five years. And now you're going to tell them you have to go back and take a physics course, you've got to take an organic course, you've got to take your MCAT and you've got to do well on it. So the research that I did showed that the MCAT course performance was lower. But once we hit our medical boards, the performance was always higher, which indicates that the MCAT is not what dictates how well someone's going to do. So developing that curriculum, thinking that the didactic was what I would be able to accelerate, I actually went to some of those PAs. And what I found out was that the didactic is exactly what they were looking for. If you talk to PAs who want to go back to medical school, it's always three things, increased depth of knowledge, autonomy, and the ability to do more for their patients. That's the first three things that they cite as the most common reasons for going back. The things that stop them from going back are the expense and the time away from clinical practice. So developing this curriculum in a three year format, what I found was that I could shorten their clinical rotations because they are already coming in knowing almost all of them know what they want to do. They've been in practice for five years. They love ER. They don't need the electives and they don't need the selectives. And we can take away their vacation and accelerate that clinical years to allow them to do it in a three year format. Interesting. And how long has that program been running now? Actually, we are just going to graduate our inaugural class this summer. And the performance outcomes have been extremely... extremely... what am I looking for? Exciting. Obviously the way we compare is board scores. How are they doing board scores wise? They're well above the mean. We have three steps to our osteopathic boards. So they're well above the national mean for first step and second step. We don't have third step until after they graduate. But on every single performance measure that we did with this group that came through, including like shelf examinations, GPAs, class rank and standing, every single one is higher than the mean. That's great. It is. It's very satisfying. So that's both good for you guys for obviously selecting the right PAs that want to go back to medical school, but good for them for having that motivation to continue. So with the PAs that you're graduating now, obviously it's your first class. So you can't talk about trends at all. But with that group that you have, are the PAs going into more of a primary care? Or are they looking to go into more subspecialties? Our school does encourage primary care. And the way we've done that is within my program, we have 12 seats per year. Six of those seats are designated as primary care, which means when you come in, you agree to do a residency and five years of clinical practice in either family medicine, general internal medicine, OBGYN or pediatrics. So those six seats are reserved for primary care applicants. The other seats are undeclared, which means they can do any residency that they want to. So all of our residencies are osteopathic that we require. But six seats say you can do whatever residency you want and six seats say primary care. The first two years of the program, we had several open slots in the primary care. This year, we do not. All of our seats are filled. How do you enforce that on the back end? Well, it's a contract, but we're physicians and we're professionals. So you have an ethic of standing towards your patients. You also have an ethical standing. If you make a commitment that you're going to follow through with this requirement, then we expect you to do that. And I don't think we're going to have any problem. You know, that's another thing about the PA groups that come in or that are coming in. About five to six years of clinical experience when they come in. We're now hitting up some of the military PAs that are finding our program and coming in. So, you know, a lot of times transitioning from undergraduate, those applicants in the medical school are still pretty young, whereas mine are more mature group. And so I don't have the concerns that in this group that you find in a lot of other medical students right out of undergraduate, they know what they want. They know why they're there. And you tell them to roll over backwards. They'll do it because they understand that what their goal is to accomplish and they're willing to do what you need to do to get there. And they also have the experience of practicing. Whereas in medical school, you kind of go through the different specialties and you're checking off the ones you don't like and circling the ones you like. A practicing PA knows what life is like, practicing as whatever they're doing and they'll either continue doing that on the flip side of medical school or they'll look for something else. So that helps. It certainly does. Yeah. So do you think being a PA before going to medical school has made you a better doctor on the other side? I really think it has. And the interesting thing about the next step in this exploration is that if undergraduate pre-med was more like PA program, minus maybe the clinical rotations, I think we would see extremely higher levels of quality physicians. Because in undergraduate, we're studying a lot of things that we don't put into practice. So, you know, when I prescribe an anti-hypertensive, I don't use physics ratios to calculate your resistance. Oh, yeah, resistance of blood flow through the arterial system when I'm prescribing a hydrochlorothiazide and nephrologist do. Yes, I'm sure they do. But that's the point of specialty medicine. You go into your residency, that's where you need to get that. But if we had everybody coming into medical school with cadaver anatomy and microbiology and embryology and medical or terminology, you know, very similar to a PA program in pre-med, then the knowledge base that that physician would come out for then four years later after medical school would be much higher than what is experienced now. And, you know, the volume of medicine just keeps getting bigger and bigger and bigger. The knowledge base is there, but we can't learn at all in medical school. You still have to have the residency to do your specialties. And that's what we're trying to do with medical school. You keep putting everything in when you can't. You have to stop putting things in so undergraduate, so place to look. Yeah. I am of the firm belief and the very unpopular belief that medical school should be five years, but nobody wants to do that. We keep shorting it to three years now. I've seen that. I've seen that too. Yeah. But see what you could do if you had an undergraduate that was changed. Yeah. And, you know, that does bring up the point about, I mentioned it earlier, is the MCAT. We do have a pilot program because we did recognize that, again, PA is about practicing 10 years and they're not going to get back and take the MCAT. So, during some other research that we looked at for alternatives to that was we found out in the University of Colorado and some other schools out the West that they use for admission from high school into six-year programs and colleges, they use something called an academic index score, which uses your SAT or your ACT in a formula with your high school GPA to give you what's called an academic index score or admission index score. And we've used, we've now started our pilot program for My Pathway, a physician accelerated physician assistant pathway where we can calculate that academic index score and use that to base an interview on instead of an MCAT. Interesting. And have you started using that yet? We did. We were using it for this year as a pilot to see how it goes. Good. Very interesting. So, for a pre-med student out there that is struggling to get into medical school maybe has applied once or twice and kind of banging their head on the wall, would you recommend that they look at going to a PA school? I guess it goes back to the traditionalist's view. I really see the PA career as a career, as a mid-level practitioner. So, I think I've been really kind of the exception of using it as a stepping stone and it wasn't based on my desire to go into a profession, use it as a stepping stone and go further. It was really back to where I came from. I didn't know of anybody that went to medical school. Very few people went to college, let alone medical school. So, I really would not recommend using the PA program as a stepping stone. Now, if you're thinking that you want to get that level of medical knowledge before you come in as a pre-med program, I wouldn't be objecting to that. And I think it would certainly give you an edge and a benefit. Now, remembering that the terminal degree now is a master's degree. So, those programs are five years anyhow. So, you're going to do a five-year program to get into a four-year medical school. I don't know a lot of people interested in investing in that either. But you can still do a lot with your electives. So, when you're out and doing pre-med, what are you taking for elective? Volleyball, bowling, square dancing. Challenge yourself. Take a human anatomy course. That's what you really want to do. And then you walk in and it's a completely different story. What general advice would you have for pre-med that is looking to go to medical school? The biggest indicator of how well you're going to do in medical school is your GPA. So, yeah, we know about the MCAT and they're changing the MCAT because the validity of that test is coming into question and it had been coming into question. They are moving more towards that ethical standing and that social consciousness as well. So, they are changing the MCAT that's coming out next year. But the GPA is really the big predictor. So, a lot of people go into undergraduate and they take their first semester to start living away from home and get into that trap of, okay, well, I learned my lesson in the first semester and then you spend the next three years trying to recover your GPA. So, you want to go to medical school. You come in from day one and you work your rear end off to get that score. And also, having a knowledge of patient care in clinical settings. So, it is very important to get exposure to that and not just shadowing with a doctor for one day. We see applications that have that, you know, I shadow with a doctor for two hours, four hours, eight hours. We like to see more commitments. So, find a place where you can become a scribe and go into the ER and you're making some money on weekends anyhow, but you're doing a scribe service. That kind of exposure that you want to see, donate your time to the community resources that are involved with medicine. Do free clinics. That shows that you want to be in medicine and then it also gives you experience because then you're not disillusioned. And that's another thing about PAs that come back to medical school is they're not disillusioned with medicine. They have not become cynical. They've seen the worst and they've seen the best and they still want to be there. So, that's the experience that they can bring to us. That's great. Where can PAs find out about the program? We're at lecom.edu and all the curriculum is described in there. It tells you exactly what you need to do. It talks about our requirements for application and the general success statistics. Like if you 3.5 as a general GPA, as a good GPA to think about applying, we have our minimums on there, of course. But 27-28 MCAT is a common average to be competitive. Good does go lower than that, but again, the lower applications don't usually aren't usually successful. I would like to say that the biggest thing I've seen in this pathway that we have, that people underestimate, there is a perception that in some of the forums that you read online says, well, I should only be able to have to go for one year or I should just be able to sit for the examination. You ask any of my PAs that come through and you're in for a rude awakening because I cannot describe how hard this curriculum is. And you, PA school curriculum, I've experienced it and it is extremely hard too, but not to what you're going to compare to yet. And you have, I tell them to buckle their seat belts when they come in and don't think you're going to be working on weekends and 20 hours a week and joining all these clubs and joining yourself because you're going to work hard. And it cannot explain. I don't want people to underestimate that. And the hardest ones to come back are the ones who have been out practicing for seven, eight, nine, 10 years and they have to go back to a basic science seat and get back into the biochemistry. Tough, really tough. Yeah. It's going from a college fastball to a major league fastball. Absolutely. Fastball is a fastball, but there's no comparing those two. That's exactly right. Awesome. All right, folks, that was Dr. Mark Kaufman, again, from Lake Erie College of osteopathic medicine, where they have an awesome accelerated program for physician assistants who want to go back into medical school, a three year program, instead of the normal four years, which is great. And I was looking, they have a link to it. They have an article on Lee Com's website that talks about only 4% of PAs actually return to medical school. And the major barriers of why more don't are the cost and time away from clinical practice, the fact that they have to go back to school. So those are some interesting numbers. If you're struggling with that decision, go on the show notes page and leave a comment, medicalschoolhq.net/63 as an episode 63. And let us know what you're thinking. Why are you leaning one way or another? It'd be interesting to get some insights. And hopefully, Dr. Kaufman, I'll get him to come on and answer some of those questions left in the comments. I also want to remind you that this podcast is brought to you by the Academy at the Medical School headquarters, an online membership site for helping you through the pre-med process. We have live monthly video question and answer sessions, monthly live webinars, covering everything from the MCAT to financial aid. You can't afford not to join. Start off your new year, right? We're now in February. By investing in your future and joining the Academy, just go to jointheacademy.net and learn all about it. Folks, as always, I hope that information provided today will help better guide you on your path to becoming a physician or a PA. And again, I hope you join us next time here at the Medical School headquarters. [Music]