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Nurse Practitioner vs. Physician Assistant

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In This Article

The nurse practitioner (NP) and physician assistant (PA) occupations share similarities and some key differences. On this page, readers can explore how the two careers compare in terms of education requirements, responsibilities, salary, and more.

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Readers can examine how to decide which career path is right for them, along with how to become an NP, and how to become a PA. This page also provides a list of professional organizations for PAs and NPs, with information about the unique advantages of membership.

Also covered below are the salary and job growth data for both professions, including the industries that offer the highest employment levels, concentration of jobs, and salary opportunities. This page examines common job settings for PAs and NPs, including specialty areas.

Key Similarities Between Nurse Practitioners vs. Physician Assistants

Both NPs and PAs are considered advanced practice providers (APP) and are vital assets to our healthcare community. These professions were created to meet the ever growing demand for primary care providers.

In the mid-1960s, physicians designed an accelerated medical school-like program to train individuals to examine, diagnose, treat, and generally care for patients without requiring the robust, in-depth education of a medical degree. Thus the PA profession was born, with NPs being established soon after. Both PAs and NPs perform several of the same day-to-day duties as physicians, and typically work with a collaborating physician.

NPs and PAs must earn a master’s degree in their discipline. During these programs, students encounter similar curriculum requirements and focus on some of the same topics, such as pharmacology, pathophysiology, and advanced health assessment.

PAs and NPs find work in similar types of settings, including physician’s offices, hospitals, and clinics. After earning their master’s degrees, PA and NP graduates must pursue licensure and pass national certification exams before they can practice professionally.

NPs and PAs can both specialize their careers. PAs, however, are trained and graduate with a general education in all fields. This allows them to work in any field of medicine right after graduation, although specific residencies for PAs are available for further postgraduate training.

NPs on the other hand, choose their field of speciality before starting their NP program and graduate as a family practice NP or mental health NP, for example. If they want to practice in a different field later on, they must undergo additional training and certification to change specialities.

Key Differences Between PAs and NPs

Although PAs and NPs share similar roles and responsibilities, the positions differ in important ways.

NPs and PAs hold some level of prescriptive authority in all 50 states, but the criteria for what and when they can prescribe without supervision may differ per state, more so for NPs. Many states require NPs to work in collaboration with licensed physicians, particularly when afforded prescriptive authority.

A student aiming to become an NP or PA generally begins by earning a bachelor’s degree. Both positions require a graduate education, but NPs generally pursue master of science in nursing (MSN) degrees, and PAs earn master’s in physician assistant studies degrees. These degree paths prepare students to sit for the certifying exams required for each position.

MSN programs require each student to already hold an active RN license, while NPs must also maintain active RN licenses while they practice. PA programs often require applicants to have some form of experience working or extensive volunteering/shadowing in the healthcare field, which may include nursing, EMT or paramedic experience, phlebotomy, and other areas.

Certification requirements for NPs sometimes vary based on the national certifying agency’s requirements. Agencies maintain different requirements, but they generally include at least 500 hours of supervised clinical practice. PAs complete at least 2,000 hours.

Although the master’s degree serves as the minimum requirement to become an NP or a PA, professionals in both careers sometimes choose to pursue doctoral degrees to advance in the field.

Salary Comparison

NPs earned a median annual salary of $113,930 in 2018, while PAs took home a median annual wage of $112,260 in 2019. Outpatient care centers provide PAs with the highest salary opportunities, and NPs can find their highest-paying opportunities within local, state, and private hospitals.

PAs and NPs both typically work full-time schedules. Depending on the work environment, these professionals might need to be available on call or work nights, weekends, and holidays.

PAs anticipate a projected job growth of 31% from 2018-2028, while the BLS projects a job growth rate of 26% for NPs over the same timeframe. NPs receive the highest salaries in California, the highest concentration of jobs in Mississippi, and the highest employment levels in New York.

New York offers the highest employment levels for PAs, Alaska boasts the highest concentration of jobs, and Connecticut features the highest salary opportunities. Physician’s offices provide the highest concentration of jobs and employment levels for PAs and NPs, with outpatient care centers, general medical and surgical hospitals, and offices of other health practitioners making up the other top industries.

How to Decide Which Career Is Right for You

Consider which position meets your professional goals and educational preferences to identify your ideal career option. Examine factors like salary potential, education requirements, the scope and flexibility of practice for each position, and the job duties commonly required for PAs and NPs. You may also want to consider the scope of practice your desired state of residence allows NPs and PAs.

Although both academic paths require graduate degrees, each path differs. NPs pursue nursing education, first earning RN licensure before completing graduate NP programs. PA programs look for students with some experience in healthcare, but this includes other areas outside of nursing, like paramedic, respiratory technician, radiology, or surgical technician work. While most nurses go the route of NP, it is not unheard of for nurses to choose the PA route instead.

NPs and PAs may choose to specialize their work or practice in general or primary care. NPs serve as advanced practice registered nurses (APRNs), which includes an education centered on nursing care. PA programs emphasize general practice, diagnosis, procedural methods, and treatment. The career you choose should mirror your goals, interests, and the specialized roles you may wish to take on.

How to Become an NP

NPs must earn MSNs before they can practice professionally. At the master’s level, nursing degrees feature concentration opportunities, allowing learners to focus their degrees on the NP pathway. Concentrations include family nurse practitioner, mental health nurse practitioner, adult-gerontology primary care nurse practitioner, and neonatology.

Concentrations include family nurse practitioner, mental health nurse practitioner, adult-gerontology primary care nurse practitioner, and neonatology.

Admission requirements for MSN programs vary depending on the college or university, but common criteria include a bachelor of science in nursing degree, a current and active RN license, and CPR certification. Learners typically must meet a minimum GPA requirement, usually around 3.0. Admission materials commonly include official undergraduate transcripts, a completed application, letters of recommendation, a personal statement, and a current resume.

At the master’s level, programs include classroom instruction and clinical experiences. Learners focus on pharmacology, advanced health assessment, and pathophysiology. Earning an MSN typically takes students about two years of full-time enrollment. Once they earn their degrees, they must pass a national certification exam in their chosen specialty of nursing, along with any state-specific requirements, to obtain their APRN licenses.

How to Become a PA

Prospective PAs should first earn a bachelor’s degree from an accredited university. While admission requirements into PA school vary depending on the college or university, high GPAs and medical experience are typically required to gain admission. All PA programs are at the master’s level which require each physician assistant student to hold a relevant bachelor’s degree and work experience.

While admission requirements into PA school vary depending on the college or university, high GPAs and medical experience are typically required to gain admission.

PA students typically take between 24-27 months to earn their master’s degrees, completing a curriculum (modeled after medical school curriculum) that covers topics such as human anatomy, physiology, pathology, and pharmacology. During their PA program, learners complete classroom, laboratory, and clinical coursework.

Relevant clinical experience for PA master’s applicants can include previous work as an RN, nursing assistant, paramedic, or EMT. Eligible applicants do not necessarily have to have medical work experience but often have volunteer experiences at clinics or hospitals.

After earning a master’s degree, each graduate must complete and pass the physician assistant national certifying examination administered by the National Commission on Certification of Physician Assistants. PAs must pass this certification exam every 10 years to maintain board certification. Once they have passed their certifying exam they must apply for and receive a license to practice from the state that they want to work in. PAs must also complete continuing education credits annually to maintain their licenses.

Professional Organizations for Nurse Practitioners

Joining a professional organization for NPs allows members to take advantage of many different benefits, including access to resources, events, and professional development ventures.

  • American Association of Nurse Practitioners: Dedicated to advanced nurse practitioner practice and improving patient care, AANP supports more than 105,000 members, including NPs, organizations, and NP students.
  • American Nurses Association: As the premier organization representing the interests of RNs across the United States, ANA aims to advance the nursing profession by promoting a safe, ethical work environment and fostering high standards for nursing practice.
  • National League for Nursing: In addition to offering professional development opportunities, this organization provides members with research grants, testing services, teaching resources, and public policy initiatives that promote nursing education programs.

  • Professional Organizations for Physician Assistants

    The following organizations can provide PAs with many helpful benefits, including events, seminars, and opportunities for professional development and networking.

  • American Academy of PA: Committed to educating PAs and their patients, AAPA represents more than 131,000 PAs across the United States, covering all surgical and medical specialties.
  • The Physician Assistant Foundation: This nonprofit organization functions as the philanthropic arm of the AAPA to promote the work of PAs, along with their patients, students, and the community.
  • National Commission on Certification of Physician Assistants: As the only certifying organization for PAs in the United States, NCCPA ensures that professional PAs meet the standards for cognitive skills and clinical knowledge necessary for effective practice.

  • Cynthia Taylor Chavoustie, MPAS, PA-C

    Cynthia Taylor Chavoustie, MPAS, PA-C is an experienced physician assistant specializing in family medicine and gastroenterology. In 2005, she obtained her MA in physician assistant studies from the University of Nebraska. She has more than 15 years of clinical experience with all ages and in many different environments. Cynthia has always been committed to public awareness and overall health for herself as well as others.

    Meredith Wallis, CNM, NP

    Meredith Wallis, CNM, NP is a certified nurse-midwife, nurse practitioner, and International Board Certified Lactation Consultant (IBCLC). She received her master’s degree in midwifery from Oregon Health & Science University in 2011. Meredith specializes in out-of-hospital birth, lactation support, and childbirth education. Her professional passions include holistic medicine, VBAC, and evidence-based care.

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