Pathways Forward

Curricula · Hands-On Healthcare · Butte & Silver Bow County

Physician & Physician Assistant: the Butte Path

Medicine is the longest road on this list: a bachelor’s degree, four years of medical school and three to seven years of residency. The physician assistant route is shorter. Both clear every income bar.

Ed. 2026–27Builds on the Butte Hands-On Healthcare core pathChecked 2026-09-26

Why this field is on the list · as of September 2026

$273k–$439kPhysician medians by specialty, Montana
$141,470Median physician assistant pay, Montana
$103,225Silver Bow County living wage, one earner, three children

Both routes clear the three-child bar. Physicians earn from about $273k to $439k depending on specialty. Physician assistants earn a median of $141,470.

The cost is time and debt. A physician usually finishes training around age 30. A PA can practice about seven years after high school.

AI exposure is low to moderate. AI helps read scans and draft notes. The exam, the judgment and the conversation with the patient stay with the clinician.

Watch for: rural and small-town family medicine is short of doctors nearly everywhere, and some medical schools have rural tracks with help on tuition. Ask about them.

01 · The ladderTwo roads to practice

  1. Pre-med bachelor’s

    Any major, with biology, chemistry, organic chemistry, physics and biochemistry, then the MCAT. Hands-on patient hours (CNA, EMT, scribe) help an application.

    Where: Montana Tech or Carroll College in Helena.

  2. Medical school (MD or DO)

    Four years. Options for students from this area include the University of Washington School of Medicine through its WWAMI site at Montana State University in Bozeman, Rocky Vista University’s Montana campus in Billings (DO), and Touro’s osteopathic college in Great Falls (confirm current admission).

  3. Residency

    Three years for family medicine, internal medicine or pediatrics; longer for surgery.

    Physician medians $273k–$439k · clears the three-child bar

  4. Physician assistant (the shorter road)

    A bachelor’s with patient-care hours, then about 2½ years of PA school. PAs practice with a physician’s collaboration and can change specialties without a new residency.

    Where: Rocky Mountain College in Billings.

    Montana median $141,470 · 25th percentile $129,750 · clears the three-child bar

02 · BranchesWhere the work leads

Family medicine

The rural doctor who sees the whole family, from newborns to the very old.

Schedule: Clinic hours with some call.

Hospital medicine and emergency

Hospitalists and emergency physicians work in shifts at St. James Healthcare in Butte and similar hospitals.

Schedule: Block schedules: a week on, a week off is common.

Specialties

Surgery, OB/GYN, psychiatry and others. Longer training, and more call in the surgical fields.

Schedule: Varies widely.

03 · For the familyThe schedule, for a father and for a mother

04 · The home-school yearsWhat to add to the core path

Grades 9–10

  • Everything in the shared core, with strong chemistry, biology and math
  • Read widely and write clearly; medical school applications reward it

Grades 11–12

After high school

  • A bachelor’s degree with the pre-med courses and patient-care hours
  • The MCAT, or the PA school prerequisites

Tie to the Verification Track

A physician checks whether the diagnosis fits every finding, not just most of them. As AI suggests diagnoses, the doctor has to catch the one that does not fit this patient. The Verification Track trains that habit.

05 · SourcesWhere these facts come from

Checked 2026-09-26