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Ask a Nurse: RN or PA program?

NurseJournal Staff
Updated February 24, 2023
    Would it make sense to complete an RN program first or go right into a PA program? This Ask a Nurse series explains the difference between an RN and a PA, costs for both programs, length of time to complete, and the similarities and differences between an NP and a PA.
    A female Asian-American psychiatric nurse holding a tablet computer is talking to her male patient. They are sitting in the doctor's office.Credit: FatCamera / E+ / Getty Images

    In our Ask a Nurse series, experienced nurses provide an insider look at the nursing profession by answering your questions about nursing careers, degrees, and resources.

    Question: My daughter is graduating next year and wants to become a PA. Would it make sense for her to complete an RN program first or go right into a PA program?

    Great question! Becoming a registered nurse (RN) or physician assistant (PA) are both great career paths. These roles are:

    • Among the fastest-growing professions
    • Some of the most trusted healthcare providers
    • Rewarding
    • Cost-efficient

    RNs and PAs work in similar settings but have different responsibilities. RNs become nurse practitioners (NPs) after practicing as a RN for several years. They then complete a master’s degree in nursing (MSN).

    As an NP, you will have similar responsibilities as a PA. These responsibilities include:

    • Assessing, diagnosing, and treating patients
    • Healthcare promotion and prevention
    • Prescribing medication
    • Care coordination
    • Managing chronic diseases and conditions

    There are four questions I would first have your daughter think about when choosing a nursing school or a PA program:

    1. What is her current academic situation?
    2. What are the costs?
    3. What is the length of time it takes to complete the degree?
    4. What are her future career goals?

    Deciding Careers Depends on Your Current Academic Situation

    Is your daughter academically prepared to apply for an RN or a PA program? The acceptance rate is very competitive. Only 20% of applicants are accepted into a PA program. Nursing school is also highly competitive. Both pathways require:

    • A passion for healthcare
    • A passion for caring for patients
    • Hands-on patient care experience either working as a medical assistant or paramedic
    • A higher-than-average GPA
    • A background in the natural sciences

    If your daughter has a few or all of these qualities, including a resume, strong recommendation letters, and a personal essay, she has a good chance of getting accepted.

    If not, she can always increase her chances by working or volunteering as a patient care worker, retaking certain science classes to increase her GPA, or concentrating on taking natural science classes, such as biology or chemistry, her senior year.

    Program Cost Should Be a Consideration

    A student can enter an RN program right out of high school. A two-year program can get you an associate degree in nursing (ADN) or a four-year program can get you a bachelor’s in nursing (BSN).

    Depending on your state, the cost of completing an ADN program or a BSN program varies. Things to consider when it comes to cost:

    • Online vs. in-person vs. hybrid classes
    • State or city school vs. private school
    • Scholarship and grant options
    • Tuition reimbursement
    • Financial aid

    One thing to note, many hospitals only hire nurses with a BSN. To become an NP, you must have a BSN. It’s important to consider the cost in the long run, depending on which nursing track you choose.

    A PA program is a master’s level program. You must have your bachelor’s degree before applying to PA school. There are only 254 accredited PA schools in the United States.

    The cost varies by state and whether you are a resident or nonresident. The average cost of a 27-month PA program is about $50,000, with costs continually rising.

    How Long Does it Take to Complete These Programs?

    If your daughter wants to take her time completing her degree, then good for her! She should take all the time she needs.

    RN Program Options:

    • The quickest way to enter the workforce and gain experience is getting an ADN. You can practice as a RN after completing the two-year program and passing the national state board exam, called the NCLEX-RN.
    • You can apply to a BSN program immediately after completing an ADN. Depending on if you work full time or part time, it can take anywhere from 2-4 years to complete. Clinical hours are included.
    • You can also skip the ADN route altogether and apply to a BSN program. Most programs require a full-time commitment. A BSN program takes about four years to complete.

    PA Program Options:

    • To apply to a PA program, you must already hold a bachelor’s degree. A PA program is a master’s level program. The program is 27 months or three academic years.
    • PA programs also require students to come with at least 3,000 hours of direct patient care. After completion, a PA student must pass the Physician Assistant National Certifying Exam to become licensed in their state.

    RN programs do not have specific patient experience requirements, but it can boost your chances of getting accepted.

    What Are Your Future Career Goals?

    When making the decision to either go to nursing school or PA school, your daughter should think about her future career goals. What kind of setting does she want to work in? Does she eventually want to open her own practice or business? Does she like the idea of always being a member of a physician-led team?

    Here are some key similarities and differences between NPs and PAs:


    • check-circleNPs and PAs have similar responsibilities, such as preventative care, assessing, diagnosing, and treating patients
    • check-circlePrescription privileges
    • check-circleWork with collaborating physicians
    • check-circleWork in hospital settings, private doctors’ offices, clinics, and speciality offices


    • x-circleAfter a certain amount of hours, NPs can work autonomously without the supervision of a collaborating physician in 12 states and Washington, D.C.
    • x-circlePAs must always work with a collaborating physician
    • x-circle$117,670NP’s median salary is
    • x-circle$115,390PA’s median salary is
    • x-circleNPs are educated in the nursing model
    • x-circlePAs are educated in the medical model

    As a nurse, you have the option of pursuing different master’s-leveled career paths. RNs can become:

    Both RN and PA Career Options Are Valuable

    Whichever path your daughter decides, there is a great need for both PAs and nurses.

    The U.S. Bureau of Labor Statistics projects the PA profession to increase 31% from 2019-2029, with registered nursing jobs increasing by 7% during the same time period. Both of these jobs are growing at a faster rate than other professions.

    For both career options, make sure she’s in great academic standing with a high GPA and taking science courses. She should start volunteering or working in a hospital setting. This can show she is serious and passionate about a career in healthcare.

    When it comes to her future goals, allow her to take some time to think about where she wants to be in her career 5-10 years from now. This will help her decide which path to take.

    In Summary

    • To become an RN or a PA, you should be in higher-than-average academic standing and have hands-on patient experience
    • To have the same responsibilities as PAs, RNs must complete an MSN
    • When deciding which career path to take, consider the program costs, how long you want to spend in school, and what your future goals may be.

    Written by:

    Portrait of Joelle Y. Jean, RN, FNP-BC

    Joelle Y. Jean, RN, FNP-BC

    Joelle Jean has been a nurse for over 10 years and family nurse practitioner for over three years. She has a background in pediatric emergency room, labor and delivery, and primary care medicine. Today, she is a senior nurse writer for NurseJournal. She lives in New York with her husband, two boys, and cat, Zuzu.

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