By: Kathleen Gaines MSN, BA, RN, CBC
After the implementation of the Affordable Care Act, the increasing aging population, and changes in medical technologies providing more complex treatment options the need for qualified medically trained healthcare providers is continuing to rise. Physician assistants (PA) have filled the void. This highly competitive career is also one of the most highly sought after.
Continuously ranked in the Top 10 of healthcare professions by U.S. News & World Report, it is an ideal for individuals interested in the medical field. Currently, it is ranked #1 in Best STEM jobs, #1 in Best Health Care Jobs, and #1 of 100 Best Jobs -- this is a hot field!
In this guide, we’ll explain what a physician assistant does, how to become one, how much they make, and more!
Part One What is a Physician Assistant (PA)?
A physician assistant is a skilled medically trained provider that oversees the medical care of individuals suffering from a variety of medical conditions.
PAs are fundamental to healthcare systems because of their ability to treat patients, their lower salaries than medical doctors, and the high reimbursement fees from insurance companies.
PAs are licensed to practice medicine under the supervision of a physician. They work closely with doctors and are educated in a medical training model that complements physician training.
Physician Assistant vs Nurse Practitioner
PAs are licensed medical professionals who can and often work independently from a physician while NPs may have to be supervised and directly report to a medical doctor. This depends on the state of practice.
Part Two What Does a Physician Assistant Do?
Physician assistants are medically trained and certified with the ability to practice in all medical settings and specialties.
PAs have the ability to treat patients independently of a medical physician. They perform a variety of duties including writing prescriptions, ordering and interpreting laboratory tests, assisting in surgery, performing minor bedside procedures, diagnosing patients, developing treatment plans, and obtaining patient histories.
Their day-to-day responsibilities vary depending on the work location. Some duties of a PA include:
- Assisting in surgical procedures
- Conducting outreach programs
- Developing treatment plans
- Diagnosing injuries and illnesses
- Examining and immunizing patients
- Ordering and interpreting diagnostic tests
- Treating broken bones and wounds
- Placing IV access including central lines
- Prescribing medicine
- Researching the latest treatments options
Physician Assistant Specialties
PAs are generally trained in all areas, although some choose to specialize. Specialty areas for certification include:
- Cardiovascular & Thoracic Surgery
- Emergency Medicine
- Hospital Medicine
- Orthopedic Surgery
Part Three Physician Assistant Salary
According to the U.S. Bureau of Labor Statistics (BLS), the median salary for a physician assistant in 2019 is $112,260 per year, but conditions in your area may vary.
The lowest 10 percent earned less than $72,720, and the highest 10 percent earned more than $157,120.
Highest Paying States for Physician Assistants
The BLS, reports the following states as having the highest mean salary.
- Connecticut - $137,060
- Washington - $129,520
- New Jersey - $129,440
- Alaska - $128,530
- California - $127,520
Highest Paying Cities for Physician Assistants
Top paying metropolitan areas for physician assistants:
- Salinas, California - $161,370
- Leominster-Gardner, Massachusetts - $156,250
- Waterbury, Connecticut - $154,550
- Danbury, Connecticut - $147,500
- New Bern, North Carolina - $146,880
Highest Paying Non-Metropolitan Areas for Physician Assistants
Top paying nonmetropolitan areas for physician assistants:
- Upper Savannah South Carolina nonmetropolitan area - $202,790
- Eastern Sierra-Mother Lode Region of California nonmetropolitan area - $136,090
- Capital/Northern New York nonmetropolitan area - $132,310
- Eastern New Mexico nonmetropolitan area - $131,100
- Alaska nonmetropolitan area - $129,510
Benefits for Physician Assistants
PA roles typically come with benefits for part- and full-time workers. While actual benefits may vary depending on the institution most include the following:
- Attendance at nursing conferences
- Bereavement, family, and maternity leave
- Continuing education reimbursement
- Discounts on extracurricular activities
- Health and dental insurance
- Holiday pay and paid time off
- Relocation assistance
- Retirement options
Part Four How Do You Become a Physician Assistant (PA)?
In order to become a physician assistant, you'll need to complete the following steps:
Step 1: Earn a bachelor’s degree
Graduating with a bachelor’s degree is a must prior to applying to PA school. Most, but not all, applicants earn an undergraduate degree in a health-related field.
It's recommended to spend time shadowing a physician assistant as an undergraduate to get a sense of what the role entails.
Applicants are expected to have the following prerequisites regardless of undergraduate major.
Step 2: Get healthcare experience
All PA schools require some healthcare experience. This can be completed as clinical experience while still in undergraduate school, or as work experience after graduation for individuals that decide to become a PA later in their college experience.
Although there is no set career path, most applicants have about three years of healthcare experience in one of the following healthcare fields.
- Certified nursing assistant (CNA)
- Combat medic
- Echo technician
- EEEK or EKG technician
- Emergency medical technician (EMT)
- Health care counselor
- Lab assistant/phlebotomist
- Licensed practical nurse
- Medical assistant
- Medical social worker
- Medic or medical corpsman
- Physical/occupational therapist
- Registered nurse
- Respiratory therapist
- Surgical tech
- X-ray technologist
Step 3: Attend an accredited PA program
Most physician assistant programs are approximately 26 months or three academic years and award master’s degrees.
The coursework typically includes both classroom instruction and more than 2,000 hours of clinical rotations, with an emphasis on primary care in ambulatory clinics, physician offices, and acute or long-term care facilities.
Other rotations may include:
- Emergency medicine
- Family medicine
- General surgery
- Internal medicine
- Obstetrics and gynecology
The Centralized Application Service for Physician Assistants (CASPA) is a vital resource for applying to physician assistant degree programs.
Step 4: Get certified
After graduating from a PA degree program, the next step is to take the Physician Assistant National Certifying Exam (PANCE) administered by the National Commission on Certification of Physician Assistants (NCCPA). This is a requirement in order to gain employment.
After passing the PANCE, individuals may use the title Physician Assistant-Certified or PA-C.
The PANCE is a five-hour exam with 300 multiple-choice questions. It costs $550 to take and can be taken only once in a 90-day period.
Step 5: Apply for a state-specific license
After passing the PANCE examination, you'll begin the application process for a state license. The state license should be specific to your job. It’s important to remember that each state license has a fee and recertification rules so the more state-specific licenses held, the more costs.
Some employers will reimburse for state licensing and maintenance of the license for the duration of employment.
Part Five Where Do PAs Work?
Physician Assistants can work in a variety of settings, including inpatient and outpatient healthcare environments. They can also be found in the following peripheral healthcare settings:
- Correctional institutions
- County health departments
- Nonprofit organization
- Outreach centers
- Phone triage centers
- Private duty
- Workplace clinics
Part Six What is the Career Outlook for a Physician Assistant?
According to the U.S. Bureau of Labor Statistics, employment for physician assistants is projected to grow 31 percent from 2019 to 2029. This is exceptionally faster than other professions. There is expected to be a need for an additional 39,300 PAs by 2029.
This demand is partially due to the decrease in the number of medical doctors, the overall growth of the population, the increasing complexities of medical conditions, and the aging baby boomer generation.
Additionally, as medical technology increases and there are more treatment options available, additional PAs will be needed.
Part Seven What are the Continuing Education Requirements for a Physician Assistant?
In order to maintain certification, PAs are required to complete a minimum of 100 Continuing Medical Education (CME) credits every two years, including at least 50 Category 1 CME credits. CME credits can start being earned immediately after certification.
According to the AAPA, “Category 1 CME consists of clinical and professional educational activities that serve to maintain, develop or increase the knowledge, skills and professional performance that a PA uses to provide services for patients, the public and the profession.”
Generally speaking, the content of Category 1 CME is knowledge and skills recognized by the PA profession within medical sciences. Category 2 credit is elective and must be related to medicine, patient care, and/or other professional issues such as reimbursement and CPT coding.
Some examples include:
- Reading medical journals or texts
- Attending meetings provided by pharmaceutical companies that are promotional
- Clinical research on the internet
- AAPA HOD
- Precepting students
Refer to Statutory and Regulatory Requirements for Licensure and License Renewal (PDF) for specific state continuing education requirements.
Part Eight Resources for Physician Assistants
- American Academy of PAs (AAPA)
- Accreditation Review Commission on Education for the Physician Assistant (ARC-PA)
- National Commission on Certification of Physician Assistants (NCCPA)
- Physician Assistant Education Association (PAEA)
- PA Foundation
Part Nine FAQs About Physician Assistants
How long is PA school?
- Most programs are 26 months, or three academic years, and include all classes and clinical rotations.
Is a physician assistant above a nurse practitioner?
- This is a difficult question because there is no hierarchy between a PA and an NP. Often they are both viewed equally because of their advanced schooling and training. However, it does depend on the state of practice.
What’s the difference between a medical doctor and a physician assistant?
- There are several differences between a medical doctor and PA. While both take similar medical courses, the schooling and post-education training is very different. Medical doctors often have residencies and fellowships, depending on their specialty. Meanwhile, PAs are more generally trained and do not have to specialize in a specific field of medicine.
- Unlike medical doctors, PAs are not allowed to open their own practices. This is often seen as one of the major differences. Lastly, salary is different. According to the BLS, medical doctors tend to make substantially more than PAs. However, the student loans from medical school can be much higher.
How difficult is PA school?
- PA school is HIGHLY competitive and very difficult. According to the AAPA, PA school is no joke. Students start intense medical classes during the first semester and it is often unlike anything they have previously studied.