Physician Assistant Specialties Guide

Physician assistants (PAs) are educated as generalists, so they can work in almost any area of medicine. The American Academy of Physician Associates (AAPA) describes PAs as licensed clinicians who practice in every specialty and setting. A PA can focus on one specialty and later move to another, and more than half of board-certified PAs report having changed specialties at least once, according to NCCPA's 2025 profile of board-certified PAs (PDF).

This guide covers common physician assistant specialties and what each field involves, what PAs generally do, where PAs work most often and how to pursue a PA specialty.

What Is a Physician Assistant Specialty?

A PA specialty is the area of medicine a PA practices in, such as emergency medicine, dermatology or orthopaedic surgery. PA programs educate students in general medicine, according to AAPA, and the certified physician assistant (PA-C) credential is a general certification: the National Commission on Certification of Physician Assistants (NCCPA) states that its board certification does not convey a specialty certification. In the same FAQs, NCCPA describes PAs as grounded first in primary care or generalist practice, a base of training and knowledge that is augmented but not replaced through specialization. Our comparison of physician assistant and nurse practitioner training explains how this generalist model differs from NP education.

There are many types of physician assistants. Examples of specialties PAs report working in, from NCCPA's 2025 profile (PDF), include:

It is common for PAs to switch specialties during their careers. In NCCPA's 2025 Statistical Profile of Board Certified PAs (PDF), published in May 2026, 52.7% of PAs said they had changed specialties at least once. NCCPA's figures come from PA Profile responses from 168,768 board-certified PAs, an 83.9% response rate, collected from January 2023 through December 2025.

How to Pursue a PA Specialty

Graduating from an accredited PA program and passing a national certification exam are among the requirements for becoming a physician assistant. To take the Physician Assistant National Certifying Examination (PANCE), NCCPA requires graduation from an entry-level PA program accredited by ARC-PA, the Accreditation Review Commission on Education for the Physician Assistant. ARC-PA's accreditation standards, effective September 1, 2025, require programs to award a master's degree. According to NCCPA, all U.S. states, the District of Columbia and the U.S. territories rely on NCCPA certification as one of the criteria for initial licensure or regulation of PAs.

A board-certified PA may be able to apply for a Certificate of Added Qualifications (CAQ) within certain specialties. The CAQ is a voluntary credential from NCCPA, the only certifying organization for PAs in the United States. Under NCCPA's CAQ program policies, last reviewed in May 2026, an applicant needs:

• Current NCCPA board certification (PA-C)
• A current, unrestricted license to practice as a PA in at least one U.S. jurisdiction, or unrestricted privileges to practice as a PA for a government agency or in a jurisdiction that does not require licensure
• At least 75 Category 1 continuing medical education credits focused on the specialty, earned within six years
• A set number of hours of PA experience, which varies by specialty and must be earned within six years; for nephrology, for example, NCCPA requires 4,000 hours of practice as a PA, including at least 2,000 hours in nephrology
• An attestation from a collaborating physician or a senior or lead PA in the specialty that the PA can apply the knowledge and skills the specialty requires
• A passing score on the CAQ exam

For Hospital Medicine and Psychiatry, the policies also allow completion of an NCCPA-approved supervised PA postgraduate program to replace that specialty's listed requirements other than the exam. NCCPA says a CAQ should never be described as specialty board certification. The same policies list CAQs for the following PA specialties:

• Cardiovascular and Thoracic Surgery (CVTS)
• Dermatology
• Emergency Medicine
• Hospital Medicine
• Nephrology
• Obstetrics and Gynecology
• Occupational Medicine
• Orthopaedic Surgery
• Pediatrics
• Palliative Medicine and Hospice Care
• Psychiatry

The same policies include a Geriatric Medicine CAQ, which NCCPA's CAQ overview lists as coming soon. Our guide to physician assistant certification explains how PAs earn and maintain the PA-C.

Do PAs need a residency to specialize?

No. A PA postgraduate residency or fellowship is optional. ARC-PA accredits clinical postgraduate PA programs separately from entry-level PA programs. In NCCPA's 2025 profile (PDF), 5.8% of PAs said they had completed a PA postgraduate program.

What Can a PA Specialize In?

Generally, according to AAPA, PAs can take medical histories, conduct physical exams, diagnose and treat illness, order and interpret tests, develop treatment plans, prescribe medication, counsel on preventive care, perform procedures, assist in surgery, make rounds in hospitals and nursing homes, and do clinical research. AAPA notes that a PA’s specific duties depend on the setting, the PA’s level of experience, the specialty and state laws.

NCCPA's 2025 profile shows where PAs practice. Of the 142,239 board-certified PAs who reported a principal clinical position, these were the largest named specialty areas, according to the NCCPA 2025 Statistical Profile of Board Certified PAs (PDF):

Another 11.9% of PAs reported a principal clinical position in a category NCCPA lists as "other," where the most frequent responses included urgent care, acute care, aesthetics, wound care and trauma surgery.

The list below describes what each of these medical specialties covers, based on the American Board of Medical Specialties’ (ABMS) 2027 Guide to Medical Specialties (PDF) unless another source is linked. It describes each field, not the duties of every PA who works in it:

• Addiction Medicine - The prevention, evaluation, diagnosis and treatment of people with addiction and substance-related health conditions.
• Adolescent Medicine - Health care centered on the physical, psychological and social characteristics of adolescents and their health care problems and needs.
• Anesthesiology - Anesthesia for patients undergoing surgical, obstetric, diagnostic or therapeutic procedures, while monitoring the patient’s condition and supporting vital organ functions.
• Critical Care Medicine - The diagnosis, treatment and support of critically ill and injured patients, including those with sepsis, respiratory failure, multiple organ dysfunction and trauma.
• Dermatology - The diagnosis and medical and surgical management of diseases of the skin, hair, nails and mucous membranes.
• Emergency Medicine - Immediate recognition, evaluation, care, stabilization and disposition of adult and pediatric patients with acute illness and injury.
• ENT/Otolaryngology - Medical and surgical care for diseases, allergies, disorders and injuries of the ears, nose, sinuses and throat and of the respiratory and upper alimentary systems.
• Family Medicine/General Practice - Front-line health care that is comprehensive and continuous over time for people of all ages, life stages, backgrounds and conditions.
• Hospice and Palliative Medicine - Care for patients with serious and life-limiting illness, at any point in the course of the disease.
• Hospital Medicine - Care of acutely ill patients in hospital settings, the role ABMS describes for internal medicine physicians working as hospitalists.
• Internal Medicine - The prevention, diagnosis and management of a wide range of health conditions in adolescents and adults.
• Obstetrics and Gynecology - Surgical and medical care promoting the health of women across all stages of life.
• Occupational Medicine - The health of workers, including the ability to perform work and the physical, chemical, biological and social environments of the workplace; the American Board of Preventive Medicine calls this field occupational and environmental medicine.
• Ophthalmology - Eye and vision care.
• Pain Medicine - The diagnosis and treatment of acute or chronic pain, or pain related to cancer, in hospital and outpatient settings.
• Pathology - The causes and nature of disease, contributing to diagnosis, prognosis and treatment.
• Pediatrics - The physical, emotional and social health of children from birth to young adulthood.
• Preventive Medicine/Public Health - Promoting health, preventing disease and managing the health of communities and defined populations.
• Psychiatry - The evaluation and treatment of mental, addictive and emotional disorders, such as psychotic, mood and anxiety disorders.
• Radiology - The use of X-rays, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
• Surgery - In general surgery, the diagnosis and care of patients with diseases and disorders affecting the abdomen, digestive tract, endocrine system, breast, skin and blood vessels.
• Urology - The diagnosis and treatment of disorders of the urinary tracts of males and females and of the male reproductive system.

Is a PA Specialty Worth It?

Career and education choices are highly personal and based on individuals’ unique interests and goals. There is no career path that is better than another, it’s just a matter of finding an occupation that is rewarding for you.

As a PA or PA-C, you may have a high degree of career flexibility in being able to switch to a different specialization if you choose: more than half of the PAs in NCCPA's 2025 profile (PDF) said they had changed specialties at least once. Pay is another consideration. According to the U.S. Bureau of Labor Statistics (BLS), physician assistants had a median annual wage of $135,880 in May 2025, and the middle half of PAs earned between $120,670 and $163,980. BLS does not publish PA wages by specialty, but it does report them by industry. In May 2025, PAs in outpatient care centers had an annual mean wage of $154,390, compared with $145,880 in general medical and surgical hospitals and $136,130 in offices of physicians. These figures cover PAs at all experience levels and do not represent starting pay. Our physician assistant salary and career guide covers PA pay in more detail.

Physician assistant specialty FAQs

Do PAs choose a specialty in PA school?

No. PA programs educate students in general medicine, according to AAPA, and graduates earn NCCPA's general PA-C certification, which NCCPA says does not convey a specialty certification. Specialization builds on that base: NCCPA describes PAs’ generalist training as augmented but not replaced through specialization, and 5.8% of PAs in NCCPA’s 2025 profile (PDF) said they had completed a PA postgraduate program after graduating from their PA program.

Do you need a CAQ to work in a specialty?

No. NCCPA describes the CAQ as a voluntary credential that board-certified PAs can choose to earn, not an NCCPA requirement for working in a specialty. Check the requirements of any specific role you are considering.

Which PA specialty pays the most?

BLS, the federal source for occupational wage data, does not publish physician assistant wages by specialty. Its May 2025 estimates do show differences by industry: among the industries BLS reports for PAs, the federal executive branch had the highest annual mean wage, at $163,530.

Is a PA the same as a doctor?

No. PAs are a separate profession with their own certification and licensure. AAPA notes that PAs are educated at the master's degree level, in programs of about 27 months that include more than 2,000 hours of clinical rotations. Our guide to the differences between a physician assistant and a doctor compares the two roles.