Preparing for a career as a physician assistant (PA)

What is a PA? #

A physician assistant is a health care professional licensed to practice medicine with physician supervision. PA’s conduct physical exams, diagnose and treat illnesses and injuries, order and interpret lab tests and x-rays, counsel on preventative health care, assist in surgery, and write prescriptions.  They often serve as patient primary care providers.  PAs practice in all areas of medicine: primary care, emergency medicine and trauma, surgery, surgical sub-specialties, and in all other areas of practice.  

Most PAs function as members of a team.  In some settings a PA may be the primary healthcare provider, practicing under the supervision of an off-site physician. Some states even allow PAs to operate their own practices, again, under the supervision of an off-site physician.  The manner in which a PA is supervised by the physician depends on the laws of the given state, the specific healthcare setting, and the guidelines agreed upon by the PA and physician.  

Historically, the PA profession was created so that healthcare providers such as nurses and paramedics could expand on their knowledge and experience in caring for patients to advance into assisting physicians with diagnosis and treatment.  In recent years the practice of PA’s has expanded.

More information on the PA profession is available on an infographic from the AAPA.

Physician assistant or physician? #

Many students consider whether to become a physician assistant or a physician. How do you decide? Physicians and physician assistants need similar abilities and skills.  Compassion, empathy, effective communication, leadership, resilience, cultural humility, life-long-learning, strong analytic thinking skills, self-assessment and integrity are common to both professions. Patient care is central to both careers. 

There are some significant differences, too:

  • Ultimate Responsibility: While PA’s diagnose and create treatment plans for patients, the supervising physician has the ultimate responsibility for the well-being of the patient and the outcomes.  It is the supervising physician, not the PA, who carries malpractice insurance. States vary on the degree of supervision by the physician, ranging from reviewing and signing off on every patient care decision to reviewing a percentage of these annually.

  • Lateral mobility: PA’s can move more easily between disciplines of medicine.  To change to a different field of medicine, a PA needs only to be hired to work under a physician who will provide training in the new field. Physicians who wish to change disciplines of medicine have to go back into residency for one or more years.

  • Length of Education: The training required to become a PA is shorter, meaning you would more quickly begin to practice as a professional.  The average length of training for a PA student is 27 months (programs range from 24 to 30 months).

A useful infographic can be found at

To help you determine your path, arrange clinical observation  (job shadowing) of both PAs and physicians so you can learn about the distinctions, commonalities, and collaborative styles between the two professions.  You can also gain insight by exploring the career and education information on professional organization sites affiliated with each field at AMA and AAPA.

Physician assistant (PA) or nurse practitioner (NP)? #

Some students consider whether to become a PA or nurse practitioner (NP). Patient care responsibilities for PA’s and NP’s are identical in many settings. The path you take to get into these similar careers is very different. To become a nurse practitioner you must first be admitted to nursing program and undergo training as a nurse.

The length of formal training is roughly the same for NPs and for PAs; both complete a master’s degree program (about 24 - 30 months).

Following are some general contrasts between these professions:

  • PA’s can specialize by simply training with physicians in different areas of medicine. It is not as easy for an NP to move into another area of specialization without obtaining further schooling and certifications.

  • Depending on state laws, NPs often can operate their own medical practices and function more independently than PA’s; fewer states allow PA’s to operate their own practice.

  • PA’s are covered by the physician's insurance; generally, NPs must have their own insurance.

  • PA’s are trained according to a diagnostically-centered medical school model. Nurse Practitioners are trained according to the holistic care model of the nursing profession.

A chart comparing physician, PA and NP pathways can be found on the Physician Assistant Life website.

For salary information visit the Occupational Outlook Handbook. For articles about the PA profession visit AAPA Bibliography.