What is a physician assistant? Physician assistants (PAs) are health care providers who work in a variety of settings, from clinics, colleges and private medical practices to outpatient surgery centers and hospitals. While PAs practice under the guidance of a physician and collaborate with other health care providers, many PAs maintain a significant amount of professional independence. A physician assistant’s day-to-day work may include documenting patient histories, diagnosing illnesses, developing treatment plans and prescribing medications for patients.

There are more than 131,000 certified physician assistants practicing in 23 specialties and subspecialties in the United States, according to the 2018 Statistical Profile of Certified Physician Assistants by Specialty report (PDF, 4.4 MB), published by the National Commission on Certification of Physician Assistants.

Getting into PA school and becoming a PA takes hard work, commitment and a genuine desire to help others. It may also take time to find the best PA program for you. The American Academy of PAs (AAPA) recommends the following six steps to becoming a physician assistant:

AAPA indicates that majoring in a science, such as biology or chemistry, is a plus.

To get into PA school, you may need to take additional courses such as statistics, biological sciences, chemistry, or psychology to qualify for a PA program, even if your college major does not require them. Specific requirements will vary by school.

PA programs typically require at least 1,000 hours of experience in one or both of the healthcare experience (HCE) and patient care experience (PCE) areas. Types of work experiences may include volunteer or paid positions—like working as a medic or emergency medical technician, having Peace Corps experience or completing a summer internship in a medical office. Direct patient care like working as a registered nurse is also valued in applicants. The Centralized Application Service for Physician Assistants (CASPA)¹ and the Applicant’s Manual of Physician Assistant Programs² offer additional information on guidelines. Specific requirements will vary by school.

Explore PA schools based on cost, flexibility, accreditation, or other factors. Gather your school transcripts, records of certification, letters of recommendation and your work experience list. Next, compose an essay on why you want to become a PA. Finally, submit your application, supporting materials and essay through the CASPA application portal¹. PA programs also typically require an interview as part of the application process. The American Association of Surgical Physician Assistants (AASPA) offers helpful interview strategies³ that provide an overview of what to expect.

To be eligible to take the PANCE⁴, you may need to complete certain physician assistant education requirements, including graduating from a physician assistant program accredited by the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA). The five-hour test comprises 300 questions. If you don’t pass the first time, repeat testing is allowed.

In order to become a practicing PA, you will need to become licensed in your state. All states require that PAs graduate from an ARC-PA accredited PA program and pass the PANCE exam, according to the AAPA website page on state licensing⁵, which provides a link to a list of all 50 states’ licensing boards. To maintain national certification, you need to complete additional hours of continuing medical education based on your state’s requirements.

There are several different ways to pursue a physician assistant degree, including full-time, part-time, on-campus, and PA online degree programs. There are 246 accredited physician assistant programs in the United States, and you can explore PA programs by state on the Physician Assistant Education Association’s website (PAEA).

The benefits of an online physician assistant program include the flexibility to continue working and earning a degree at the same time, and then to go on to practice in your own community. Students are able to earn a degree from the university without relocating.

Many would-be applicants have questions regarding the various career paths to becoming a PA versus other health care professions. Below is a comparison of PA, nurse practitioner (NP) and doctor of medicine (MD) job fields.

PA-C stands for physician assistant—certified and means an individual has attended an accredited program for PAs and has put thousands of hours into the classroom instruction and clinical rotations required to practice as a PA. Additionally, PA-Cs have passed tests required by the National Commission on Certification of Physician Assistants (NCCPA). PA-Cs are recognized Medicare and Medicaid providers.

What is the difference between a PA and a nurse practitioner (NP)? Both career fields require intensive education, including a master’s degree, as well as extensive clinical hours working with patients and collaborating with other health care providers in medical settings. Both fields of patient care must obtain certification and a license to practice in their state.

PAs and NPs may also choose to specialize in a certain area of expertise. PAs are certified through the NCCPA and must pass a national certification exam. NPs obtain certification in a specific patient population focus, such as midwifery, acute care or pediatrics. However, NPs and PAs may obtain additional certifications and sub-specialize in a variety of areas such as neurology, dermatology and cardiology.

Training and scope of practice for nurse practitioners and physician assistants differ in several ways. A Master of Science in Nursing (MSN) is the minimum requirement to become a nurse practitioner. Physician assistants typically obtain a Master of Science in Physician Assistant Studies by completing a three-year, ARC-PA-accredited graduate program. NP training is based on a nursing model of care, while PA training is based on a medical model of care.

PAs and NPs have some autonomy when it comes to their practices, with oversight by a physician, but some state laws allow NPs to practice independently.

Both professions are projected to experience job growth in the years ahead, according to the Bureau of Labor Statistics (BLS). The median annual salary for PAs in 2018 was $108,610. The median annual salary for NPs that same year was $107,030.

There are several major differences between physician assistants and doctors. One of the biggest differences between PAs and MDs begins at the education and training levels. Before a degree has been conferred, MDs must go through a four-year medical school training and another three to four years (at least) of specialty training in their area of choice, such as pediatrics, orthopedics or neurosurgery. Sub-specializing in pediatric heart surgery, for example, will require even more years of training. MDs with very specialized medical expertise may end up in training for a decade or more. 

PAs, on the other hand, are required to go through a 27-month full-time program. Online PA programs may take longer.

Projections from the BLS estimate that the PA profession will experience a 31% climb from 2018 to 2028, much faster than the average for all occupations.

One reason to consider becoming a PA over other health careers is physician assistant jobs are expected to be plentiful, and the physician assistant job outlook and salaries are positive. What’s more, the required training time and years in school, while rigorous, are less than those required of physicians or surgeons.

Popular YouTuber James Kim, who shares “a day in the life” advice and information about his PA education and career path, says one reason he chose PA school instead of medical school is that PAs get to spend quality time with patients.

He advises working with or shadowing PAs and MDs if you’re on the fence about which career to pursue—doing so helped him decide which field was right for him.

“A last reason I chose physician assistant is family,” Kim said, explaining that becoming a PA seems conducive to having work-life balance yet still offers the ability to practice medicine and the reward of getting to know and help patients.

¹ Physician Assistant Education Association. (2020) CASPA – The Central Application Service for Physician Assistants. Retrieved from https://paeaonline.org/caspa/ ↑

² Volpe, M., & Hogan, B. (2018). The applicant’s manual of physician assistant programs. Retrieved from https://www.amazon.com/Applicants-Manual-Physician-Assistant-Programs/dp/1976073847 ↑

³ American Association of Surgical Physician Assistants. (n.d.). Interviewing strategies. Retrieved from https://www.aaspa.com/resources/interviewing-strategies ↑

⁴ National Commission on Certification of Physician Assistants. (2020). Becoming certified (as a physician assistant). Retrieved from https://www.nccpa.net/become-certified ↑

⁵ American Academy of Physician Assistants. (2020). State licensing (for physician assistants). ↑