Should I Become a Physician Assistant or Nurse Practitioner?

Both Physician Assistants (PA) and Nurse Practitioners (NP) play vital roles in healthcare and are deeply involved in patient care. If you are considering a career as a PA or NP, read on to learn about the educational requirements, responsibilities, and career paths of both professions.


Educational Requirements and Degrees Offered

  • Educational requirements – Both programs require at least a bachelor’s degree prior to advanced schooling. In order to become an NP, you must first have an MSN (Master of Science in Nursing) and be an RN. In contrast, PA schools typically look for general experience in healthcare. This may include experience as a medical scribe, nurse, paramedic, or healthcare technician/aide.
  • Degrees offered – Both programs offer master’s degrees. Most PA programs are between 2-3 years. In contrast, NP programs typically take between 1-2 years.


Responsibilities and Scope of Practice

  • Specialties – PA’s graduate to practice general medicine but can choose to specialize afterward. Some specialties PA’s pursue include family medicine, surgery, emergency medicine, dermatology, psychiatry, and pediatrics. In contrast, NP’s choose a specialty before starting their program. NP’s can specialize in pediatric, adult, geriatric or mental health. If you later decide that you want to change specialties, you will need to go through additional training.
  • Patient care responsibilities – NP’s have some of the same responsibilities as a registered nurse, such as assessing patients and administering medications, but also have several other advanced duties. These include patient education, diagnosing medical conditions, ordering testing, and prescribing medications. PA’s function similarly to physicians and can also diagnose, order testing, and treat medical conditions, in addition to some other roles a physician normally has. However, in most states, PA’s must have some form of collaboration with a supervising physician.
  • Autonomy – Both PAs and NPs can write prescriptions. However, PA’s ultimately work under a physician (MD/DO) who signs off on the prescription. The degree of prescription writing autonomy for NP’s depends on the state, though in all states they have at least some level of prescription writing ability. Interestingly, PA’s may occasionally be the main provider in a practice. This is especially true in rural areas where there are provider shortages and physicians are only available for consultation minimally during the work week. However, PA’s may still need physician authorization, when required by the state’s laws.

The S. Bureau of Labor Statistics reports a robust 2018-2028 projected job growth of 31% for PA’s and 26% for NP’s. These rates are much faster than average.

Salary Differences

  • The S. Bureau of Labor Statistics reports that in 2019, PA’s made an average of $112,260 per year, while NP’s made an average of $109,820 per year.


Job Opportunities and Growth

  • Hospital versus outpatient setting – Most NP’s work either at private doctor’s offices (47%) or at hospitals (27%). Similarly, most PA’s work either at private doctor’s offices (55%) or at hospitals (26%)
  • Job outlook – The S. Bureau of Labor Statistics reports a robust 2018-2028 projected job growth of 31% for PA’s and 26% for NP’s. These rates are much faster than average.


Though the PA and NP professions are incredibly rewarding and involve similar scopes of care, they vary with regard to the total length of schooling and whether they offer a patient-centered or disease-centered model of care. Despite these subtle differences, both PA’s and NP’s are crucial assets in healthcare.



Navin Ramchandani, MD
About the author

Dr. Navin Ramchandani is a Medical Doctor, Diagnostician and Owner of R&R Medical Centre in Barbados. He is also an Advanced Pediatric Life Support (APLS) International instructor with the Advanced Life Support Group (ALSG), and a Pediatric BASIC (Basic Assessment and Support in Intensive Care) international instructor. His passion is diagnosing and treating/helping people with complicated health issues to improve their overall health and quality of life.

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