Definitely agree with you on the NP mills side of things. I do think PA school has better pre-reqs and training for general medicine. And that someone that does a bachelors straight to PA will be better off than the NP mill side of things. There is still a lot to learn though for those fresh PAs and there are a ton of medical companies that throw you in without really giving you the resources to learn. It is just straight production based, get as many patients through as you can, and many new grads can struggle.

My partner is a PA and was an MA for 8 years prior, so this is where most of my info is coming from.

I also say NP because the job market for PA is a little more limited. Since PAs must practice under an MD, it can limit job searches. And you almost never see jobs that specifically are looking for a PA, it is usually either just NP or NP/PA. You can still try to apply for the NP job but a bit more of a stretch. Some of them are just familiar with NP and will tend just just keep hiring NPs. My partner has been asked in several interviews where the job posting was for NP about what PA school training consisted of, and some of these interviews were at medical centers tied to universities.

Overall though, they both generally have the very similar job opportunities. So OP’s outlook for changing to a better job could happen quicker with the NP route without having to go back and do a bachelor’s and PA school, which would cost both more money and time. Especially with the concern of being an older applicant as well.

Edit: It is also significantly more difficult to get into PA school. At one point there was some statistic that it was harder to get into PA school than Med school. Mostly just based on statistics of applications vs acceptance. Not that the study is more rigorous. Overall because there are many less PA schools. So it would be easier to get into an NP school as well and not risk getting a PA school rejection.

My parter did pretty well in school with BS in biochem and around 3.8 GPA along with all the clinical hours working as an MA. She applied for the first two years out of undergrad while working as an MA and don’t get a single interview. Then just decided to work for a while with the intent to get more experience and references to apply later. Even then, only got one interview and luckily accepted.

Obviously everyone is different, but just some added n=1 info.

Would recommend the NP route, especially starting as an RN.

King Gizzard & the Lizard Wizard

Edit: that is assuming too late as in “wish I would have been into this band in high school” and not “half the band has died or they are broken up”