NP vs PA: Choosing Between Nurse Practitioner and Physician Assistant Fields

Student researching NP and PA programs


For those considering graduate study and a career in healthcare, a common question we hear is “just how different are physician assistants and nurse practitioners?” While not the only patient care centered careers that are appealing to students not looking towards medical school, the Nurse Practitioner (NP) and Physician Assistant (PA) fields are growing, respected, and popular healthcare fields. Deciding whether to go NP vs PA can be difficult, which is why this article explores the differences and similarities between the two jobs, particularly focusing on the graduate application process and education for each.

What is a Physician Assistant?

Trained as generalists, PAs practice medicine across specialities and settings from hospitals to physician’s offices. PAs have a rigorous training and education before licensure, consisting of at least a 27 month Masters of Science, Physician Assistant Studies (MS-PAS) program. Consistently ranked as one of the top healthcare jobs, the PA field is in high demand – with some estimates projecting a 30% growth in PA jobs over the next decade. According to the American Academy of Physician Associates (AAPA) three quarters of all graduating PAs receive multiple job offers as they leave school. The median pay for PAs in 2023 was $130,020. Most PAs are required to work under the direct supervision of a physician or surgeon.

What do Physician Assistants Do?

The PA profession covers a wide range of duties from taking patients’ medical histories to conducting physical exams. Trained using a medical model similar to physicians, PAs learn to test for, diagnose, and treat diseases that patients present with. They will order and analyze tests and develop treatment plans for those in their care. This includes prescribing medication and counseling patients on preventative care. Some PAs assist in surgeries, perform procedures, and conduct clinical research.

How are Physician Assistants Trained?

Using a curriculum modeled after medical school training for physicians, PAs learn about the pathology of diseases and the biological basis for diagnostics and treatment. Their generalist training involves completing their MS-PAS at an accredited PA program and completing, at minimum, 2,000 hours of supervised clinical practice hours. PA programs are generally full-time and include coursework across medical sciences, lab work, and clinical rotations. PA students often describe their education as fast paced, rigorous, and intense. After graduate prospective PAs must take and pass the Physician Assistant National Certifying Examination (PANCE) to receive state licensure.

How Hard is it to Get into a PA Program?

Getting into a PA program is often a competitive process, with many prospective students applying over multiple cycles before receiving an admissions offer. Each year around 27,000 people apply to PA programs with about 20% of applicants receiving an offer of admission. Applying to multiple programs will enhance your chances of an acceptance letter. While programs have differing requirements for patient care hours, the average amount of hours for matriculating PA students is around 2,700. For a competitive application, we’d recommend at least 2,000 hours of patient care experience before applying; a higher number may help you stand out from the crowd. Just over half of all PA programs require the GRE with the average overall score for successful applicants being around 303. Because of the highly competitive nature of PA program admissions, a great score on the GRE can help you stand out even at programs that accept, but don’t require the test. The average GPA for accepted students in PA programs is 3.6, with many students exceeding that.

What is a Nurse Practitioner?

Like Physician Assistants, Nurse Practitioners have extensive and rigorous advanced clinical and educational training. Where PAs follow the medical model of training and focus on diagnosing and treating the disease a patient presents with, NPs center their care around the patient focusing on the patient’s whole health in treating disease. Like the PA field, the NP field is reliably cited as one of the best healthcare jobs available. Along with Nurse Anesthetists and Nurse Midwives, the U.S. Bureau of Labor Statistics projects the NP field to grow by nearly 40% in the next decade. The average median pay for people in those three nursing fields in 2023 was $129,480.

What do Nurse Practitioners Do?

Their advanced nursing training allows them to perform duties beyond that of a Registered Nurse (RN) and while in 11 states NPs must work under the supervision of a physician in another 27 nurse practitioners are free to operate their own primary care practices with autonomy. They provide patient centered care focusing on the whole health of their clients from preventing disease, diagnostics, treatment plans, and, in some states, medication prescription. Nurse practitioners can work in primary care or urgent care settings and due to their training, often are more specialized in their practice than PAs.

How are Nurse Practitioners Trained?

In order to become an NP you must be licensed as an RN, have a Bachelor of Science in Nursing (BSN), complete a master’s or doctoral NP focused graduate program, and pass your national NP board certification exams. Unlike PAs, Nurse Practitioners are not generalists and take specialized training in their graduate nursing programs. Most NPs work almost exclusively with a particular population focus – areas of population focus include gerontology, pediatrics, women’s health, and psychiatric mental health among others.

How Hard is it to Get into a NP Program?

NP programs require a specific bachelor’s degree and licensure as an RN in order to attend which involve a great deal of hard work. However, on average, gaining admission to PA school is more competitive than gaining admission to an NP program. Part of this has to do with the fact that there are fewer PA programs than NP programs. Part has to do with PA programs generally having higher GPA requirements – NP programs often will set their GPA minimum at 3.0. NP programs also often have much lower clinical patient care experience hours required. Over the past few years the average NP acceptance rate was around 66%. With that said, the acceptance rate at top nurse practitioner programs is much lower.

How Do I Decide?

Start by doing your research to weigh for yourself the NP vs PA question. Check out the American Association of Nurse Practitioners, the American Nurses Association, the Physician Assistant Foundation, the Physician Assistant Education Association, and the American Academy of Physician Associates. Think about your goals, interests, and the ways you would like to work with patients. Talk to trusted advisors, friends, and mentors. The best choice is the one that aligns with the kind of work you find fulfilling, exciting, and stimulating. Check out our blog for more tips on applying to graduate school and acing the GRE!