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Nurse Practitioner vs. Physician Assistant: What’s the Difference?

January 21, 2022 · 5 Min Read

Reviewed by Shrilekha Deshaies

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There are unique differences between PAs and NPs. This guide compares factors like salary, education, and skills to help you choose your career.

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Nurse Practitioner vs. Physician Assistant: What’s the Difference?
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Prospective students considering an advanced degree in healthcare may want to learn the similarities and differences between nurse practitioners (NPs) and physician assistants (PAs). Both options provide career alternatives to professionals who wish to work in advanced healthcare roles, but not as physicians.

An NP attends a nursing school, while a PA attends a medical school or center of medicine. Nurses follow a patient-centered model and handle assessment, diagnosis, and treatment. Physician assistants follow a disease-centered model. They also practice assessment, diagnosis, and treatment.

NPs can specialize in several areas, including gerontology, mental health, pediatrics, and women's health. PAs have a more generalized education, but they can also specialize in areas like emergency medicine, orthopedics, and general surgery.

When thinking through the similarities and differences between physician assistants versus nurse practitioners, keep in mind their different healthcare philosophies, educational options, and specializations to determine which might be the best fit for you.

Side-by-Side Comparison

The table below features a side-by-side comparison of nurse practitioners and physician assistants. It includes training, licensing and certifications, and pay and career outlooks.

Both NPs and PAs play important roles in healthcare. According to the Association of American Medical Colleges, the U.S. could see a shortage of 100,000 physicians by 2030. Additional NPs and PAs will need to step in to fill vital healthcare roles.

NURSE PRACTITIONER PHYSICIAN ASSISTANT

ROLE

NPs may practice independently in some states. They perform physical assessments, order and interpret diagnostic tests, manage treatment, and coordinate care. They also provide patient education and counseling.

According to the American Medical Association, PAs working under a physician's supervision are authorized to perform physical assessments, diagnose and treat illnesses, order and interpret tests, and assist in surgery.

NUMBER PRACTICING IN THE U.S.

220,300 as of 2020, according to the U.S. Bureau of Labor Statistics (BLS)

129,400 as of 2020, according to the BLS

PAY

The median annual wage, as of May 2020, was $111,680 for NPs, according to the BLS.

The median annual wage for PAs, as of May 2020, was $115,390, the BLS reports.

EXPECTED JOB GROWTH

52% from 2020 to 2030, much faster than the average for all occupations (8%), according to the BLS

31% from 2020 to 2030, much faster than average as per the BLS

ANTICIPATED NUMBER OF NEW POSITIONS AVAILABLE BY 2030

114,900

40,100

Meeting the Requirements

NURSE PRACTITIONER PHYSICIAN ASSISTANT

DEGREE REQUIREMENTS

NPs need a minimum of a master of science in nursing (MSN) degree from an accredited school to become licensed within a state.

Even though the American Association of Colleges of Nursing (AACN) recommends the doctor of nursing practice (DNP) as the new NP standard, states and credentialing entities still just require a master's degree.

PAs need a minimum of a master's degree from an accredited medical school or center of medicine to seek licensure.

DEGREES AVAILABLE

An NP can seek a master's or DNP from a nursing school, although the AACN suggests the DNP.

More than 200 PA programs, most of which offer master's degrees, were available in 2020, according to the BLS.

PROGRAM DETAILS

NPs typically choose a specialty area and need to complete 500 instructional hours and between 500-700 clinical hours (1,000 for DNPs).

PAs receive generalist training and typically complete about 1,000 instructional hours and more than 2,000 clinical hours.

SCHOOL ACCREDITATION

NP programs typically hold accreditation through the Commission on Collegiate Nursing Education or the Accreditation Commission for Education in Nursing.

PA programs hold accreditation through the Accreditation Review Commission on Education for the Physician Assistant.

You can find a list of PA programs through the Physician Assistant Education Association.

Certification and Licensing

NURSE PRACTITIONER PHYSICIAN ASSISTANT

CERTIFICATION

NPs can seek national certification in their specialty through the American Nurses Credentialing Center or the American Association of Nurse Practitioners (AANP).

PAs need to pass the Physician Assistant National Certifying Examination available through the National Commission on Certification of Physician Assistants (NCCPA).

LICENSING

Candidates for state licensure as NPs must hold a registered nurse (RN) license, a master's or doctoral degree, and national certification.

Candidates seeking state licensure as PAs must hold a master's degree from an accredited school and national certification.

LICENSING AGENCY

NPs seek licensure through a state board of nursing or board of medical examiners. The AANP provides links to the licensing agencies.

PAs seek licensure through a state medical board, board of medical examiners, or similar agency. You can find a list of state licensing agencies through the NCCPA.

RECERTIFICATION

NPs must earn recertification every five years or less, depending on their population focus and credentialing entity.

They may sit for the appropriate exam or complete a minimum 1,000 hours of clinical practice and 75-150 continuing education units in their NP specialty.

PAs need to complete 100 hours of continuing medical education hours every two years and an exam every six years.

Details About the Job

NURSE PRACTITIONER PHYSICIAN ASSISTANT

PRACTICE FRAMEWORK

NPs often work with physician oversight. However, NP practice authority varies by state, and in almost half of states, NPs can possess full-practice authority.

PAs cannot work independently of physicians, although similar to NPs, there's a growing movement toward independent PA practice authority.

Nurse Practitioner and Physician Assistant Similarities and Differences

As advanced practice providers, NPs and PAs are vital assets to the healthcare community. Both help meet the growing demand for primary care providers.

While both hold some level of prescriptive authority in all 50 states, the criteria for what and when they can prescribe without supervision may differ by state. Many states require NPs with prescriptive authority to work in collaboration with licensed physicians.

Education Requirements

NPs and PAs must earn a master's degree in their respective discipline. Both NP programs and physician assistant programs feature similar coursework and focus on topics like pharmacology, pathophysiology, and advanced health assessment.

NPs can pursue nursing specialties. PAs receive a general education that allows them to work in any area of medicine right after graduation. Specific residencies are available for PAs seeking postgraduate training.

In contrast, NPs choose a MSN degree specialty before starting their program. For example, they can graduate as a family practice NP or mental health NP. Those who want to practice in a different field later must receive training and nursing certification.

Licensure and Certification

MSN programs for NPs require each student to hold an active RN license. NPs must maintain licensure while they practice. PA programs often require applicants to have experience in the healthcare field which may include nursing, emergency medical technician or paramedic experience, phlebotomy, and other areas.

Certification requirements for NPs vary according to specialty. While agencies have different requirements, they usually include at least 500 hours of supervised clinical practice. PAs complete at least 2,000 hours.

Salary

NPs earned a median annual salary of $111,680 in 2020, while PAs took home a median annual wage of $115,390 in 2020, according to the BLS. Outpatient care centers offer PAs the highest salaries, and NPs can find high-paying opportunities within local, state, and private hospitals.

Both PAs and NPs 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 can anticipate a projected job growth rate of 31% from 2020-30, while the BLS projects a job growth rate of 52% for NPs in the same period. Both projections are far above the 8% national average growth rate.

Top Nurse Practitioner Programs

How to Decide Which Career Is Right for You

Prospective PAs and NPs should consider factors like salary, educational requirements, the scope and flexibility of practice for each position, and individual job duties before choosing their career path. Scope of practice laws in the candidate's state of residence may also influence the decision-making process.

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 choose the NP route, it is not unheard of for nurses to become PAs. The decision reflects the candidate's goals, interests, and chosen specialty area.

NPs and PAs may choose to specialize their work or practice in general or primary care:

  • NPs serve as advanced practice registered nurses, which includes an education centered on nursing care.
  • PA programs emphasize general practice, diagnosis, procedures, and treatment.

Frequently Asked Questions About NPs and PAs


Is NP higher than PA?

Neither profession ranks "higher" than the other. Both occupations work in the healthcare field, but with different qualifications, educational backgrounds, and responsibilities. They also work in different specialties.

In addition, although both nurse practitioners and physician assistants work with more independence than nurses or aides, both often need some physician oversight.

Do PAs make more than nurse practitioners?

On average, yes. The BLS reports that the average annual wage for nurse practitioners was $114,510 as of May 2020, while physician assistants reached $116,080. That said, income varies in different locations and at different healthcare facilities.

Can nurse practitioners and physician assistants prescribe medications?

This question does not come with a clear-cut answer. For the most part, yes. However, some states impose limitations on the type of medications that nurse practitioners and physician assistants can prescribe. Those restrictions usually include Schedule II medications, but each state sets different rules.

What is the difference between nurse practitioner and physician assistant?

Nurse practitioners and physician assistants work in similar capacities. However, NPs come from a nursing background, while a physician assistant comes from a medical-school learning model.

They may also specialize in different categories. Physician assistants are more likely to go into a surgical specialty, for example, while nurse practitioners may focus on areas like adult-gerontology, pediatrics, or women's health.

Page last reviewed November 28th, 2021

NurseJournal.org is an advertising-supported site. Featured or trusted partner programs and all school search, finder, or match results are for schools that compensate us. This compensation does not influence our school rankings, resource guides, or other editorially-independent information published on this site.

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