Physician assistants (PAs) are state-licensed, nationally certified medical professionals that practice medicine in a variety of health care settings.
By the year 2025, the Association of American Medical Colleges predicts there will be a national shortage of physicians. This decline, coupled with an aging population and growing demands for health care coverage, means physician assistants are well-positioned for employment opportunities.
Read on to learn more about this promising career, including day-to-day tasks, salary information, and how to become a physician assistant.
What is a physician assistant?
Physician assistants are responsible for assisting patients under the supervision of physicians and surgeons in every field of medical practice, including pediatrics, gerontology, internal medicine, and oncology. PAs practice in all 50 states.
What does a physician assistant do?
The exact duties of a PA depends on the health care setting in which they work (e.g. primary care, emergency medicine, etc.) and on the working relationship they have with their supervising physician or surgeon. For example, a physician assistant in the operating room closes incisions and cares for the patient before and after the surgery. That said, the Bureau of Labor Statistics (BLS) reports that most PAs generally do the following on a typical day of work:
- Conduct physical examinations and review medical histories.
- Order x-rays or blood tests, and analyze results.
- Diagnose and treat injuries and illnesses and prescribe medicine.
- Educate patients and families.
- Take responsibility for the quality of patient care by tracking patient progress and researching the latest trends in medical treatment.
In some settings, such as rural areas where there are shortages in medical staff, physician assistants may serve as primary care providers at clinics where a physician is only available on a limited basis, the BLS says.
How to become a physician assistant
Becoming a PA requires the completion of a graduate program of study at an accredited school and attaining certification at the national and state levels.
Physician assistant prerequisites
Before entering a master's program, students should already have completed a bachelor's degree with a set of program prerequisites that include work in the sciences (e.g. biology, chemistry, anatomy, and physiology) and the non-sciences (e.g. psychology, English, statistics). Other major requirements may include the following:
- GRE or MCAT examinations -- Students may be required to take either the MCAT or GRE examination.
- Minimum GPA -- Programs may require students to hold at least a 2.7 GPA or greater in prerequisite coursework.
- Clinical experience -- Most programs prefer candidates with hands-on clinical experience in patient care. Examples are working as a medical assistant, registered nurse, licensed practical nurse, radiologic technician, etc.
- Shadowing experience -- Prospective candidates may be a more attractive applicant with physician assistant shadowing experience.
- Community service -- Applicants may also be asked about their community service activities.
Physician assistant education requirements
The Accreditation Review Commission on Education for the Physician Assistant, Inc. accredits PA programs that train and prepare graduates to become practicing primary care clinicians. The curriculum includes integrated coursework in many areas, including some of the following:
- Medical sciences
- Human anatomy
- Clinical laboratory science
- Medical ethics
The first year of study is traditionally dedicated to foundational training in the clinical sciences, clinical medicine, and specialty care through a series of workshops, classroom instruction, lectures, small group activities, and clinical experiences. The remainder of the program consists of intensive clinical training and practicums, with a focus on primary care in a variety of clinical settings and different patient populations.
The goal of this comprehensive curriculum is to develop advanced knowledge of and skills in the following areas:
- Physical assessment
- Laboratory and radiological principles
- Foundations of primary care
- Health behavior
- Patient education
Physician assistant certification requirements
PAs must be certified on the national level by passing the Physician Assistant National Certifying Examination (PANCE) sponsored by the National Commission on Certification of Physician Assistants (NCCPA), as well as on the state level. Most states only require that you've passed the PANCE exam and that you have certification from an accredited PA program. After obtaining a state license, PAs are certified to practice medicine under the supervision of a physician.
In order to qualify to take the PANCE exam, students must complete a minimum of 2,000 hours of primary care clinical rotations, according to the American Academy of Physician Assistants. This clinical training provides students with the opportunity to provide preventative, therapeutic, diagnostic, and health maintenance services in both hospital and clinic settings. Rotations are divided between specialty areas of practice, such as family medicine, pediatrics, obstetrics, gynecology, emergency medicine, and more.
How long does it take to become a physician assistant?
Typically, each program requires approximately three years of full-time study to complete (33 to 36 months) divided between classroom-based instruction and clinical training. Although the traditional focus is primary care, PAs can complete training in a range of specialized areas of practice, such as pediatrics or psychiatry.
What is the difference between a physician assistant and a nurse practitioner?
Though there are similarities, Nurse Practitioners (NPs) and PAs are two distinct career groups, and the differences can impact everything from how they train to how much they will earn.
- Both NPs and PAs must earn at least a master's degree from an accredited program.
- According to the BLS, both NPs and PAs perform the following tasks on the job: review and update patients' medical histories; examine patients; diagnose and treat medical problems; order and interpret diagnostic tests; educate patients and their families in matters of health; and research the latest treatments and technologies impacting their fields.
- The BLS reports that both NPs and PAs serve as primary and specialty care providers, often specializing in a particular area of medicine, like dermatology, geriatric medicine, emergency care, and even psychiatry.
- Both professionals work independently, though they may report to or collaborate with doctors, surgeons, and other medical professionals.
- Certification through the completion of minimum education and experience requirements, in addition to passing a national licensing exam, is required for both PAs and NPs.
- Like NPs, PAs must complete continuing education courses to maintain licensure.
- One more key characteristic NPs and PAs share: They are in demand, thanks in large part to an aging population requiring more medical care and shifts in health legislation that expand patient access.
- According to the BLS, all states allow PAs to prescribe medications; not so for all NPs.
- The BLS reports that while all states recognize PAs, not all states recognize NPs.
- PAs must get recertified every 10 years.
- The BLS reports that though many NP training programs prefer to admit applicants with bachelor's degrees in nursing, some schools offer bridge programs for registered nurses with lower degrees who want to segue into the field more efficiently.
- Virtually all PA degree programs require candidates to hold relevant bachelor's degrees for admission; the bridge programs that help experienced nurses become NPs more efficiently are unheard of in the PA field.
- NPs may choose to specialize their training through voluntary professional certifications. PAs can choose to tailor their training to one (or more) specific areas of medicine, but unlike NPs, this specialization occurs through the course of their postgraduate studies rather than via voluntary professional certifications down the road.
According to 2014 data from the BLS, NPs make a mean annual salary of $97,990, which translates to an hourly wage of $47.11 per hour. PAs make a similar salary of $97,280 or $46.77 per hour.
What are the career prospects?
In 2014, there were more than 91,000 physician assistants employed across the United States, according to the Bureau of Labor Statistics (BLS). By 2022, another 33,300 positions are expected to be created nationally, a growth rate of 38 percent.
Projections Central reports five states, in particular, with the highest projected job growth for physicians assistants between 2012 and 2022:
- Georgia (67.9%)
- Arizona (51.3%)
- Utah (50.4%)
- Virginia (48.2%)
- Kentucky (45.3%)
There are three emerging trends that are creating a huge need for medical professionals: physician burnout, aging populations, and greater demand for health care services. All three of these issues highlight the need for a new generation of trained, qualified direct care providers.
Here are the health care settings with the greatest job growth between 2012 and 2022, according to the BLS:
- Outpatient care centers: 67.2%
- Outpatient, laboratory, and other ambulatory care services: 64.8%
- Home health care services: 58.4%
- Offices of physical, occupational and speech therapists, and audiologists: 54.3%
- Offices of other health practitioners: 52.5%
- Offices of physicians: 48.6%
- Offices of health practitioners: 48.5%
The salary prospects for physician assistants are strong. The BLS reports that the average mean annual wage for all occupations in the United States is $47,230, compared with a mean annual wage of $97,280 for PAs. Those PAs in the 90th percentile make an annual wage of $134,720 or higher, while those in the bottom 10th make $64,100 or less, according to the BLS.
According to the BLS, the top five highest-paying states (based on mean annual wage) include:
- Nevada ($112,700)
- Rhode Island ($111,180)
- New Hampshire ($109,760)
- Washington ($107,390)
- Texas ($107,390)
Data from the annual National Salary Survey of Nurse Practitioners and Physician Assistants conducted by ADVANCE reveals annual earnings for physician assistants has skyrocketed during the past decade. In fact, between 2003 and 2013, the average annual salary of full-time physician assistants rose from $76,039 to $107,268; an increase of 41 percent.
It is a great time to be in the health care field. With outstanding job growth and high wages, physician assistants are well-respected members of the health care community. To learn more about degree programs in the field, check out the schools below.
- AAPA, What is a PA?, https://www.aapa.org/twocolumnmain.aspx?id=290
- Advance Healthcare Network, NPACE Salary Report, http://nurse-practitioners-and-physician-assistants.advanceweb.com/Features/Articles/2013-National-Salary-Survey-Results.aspx
- American Academy of Physician Assistants (AAPA), https://www.aapa.org/twocolumn.aspx?id=346
- American Association of Physician Assistants, https://www.aapa.org
- ARC-PA, Accredited Programs, http://www.arc-pa.org/acc_programs/
- Association of American Medical Colleges "Help Wanted: More U.S. Doctors Projections Indicate America Will Face Shortages of M.D.s by 2020", https://www.aamc.org/download/82874/data/helpwanted.pdf
- Association of American Medical Colleges, "Workforce Issues in Health Care Reform: Assessing the Present and Preparing for the Future", https://publichealth.gwu.edu/departments/healthpolicy/DHP_Publications/pub_uploads/dhpPublication_3AE00F5B-5056-9D20-3DAEC4261F4B6AC5.pdf
- Bureau of Labor Statistics, Occupational Employment Statistics, http://www.bls.gov/oes/current/oes_nat.htm#00-0000
- Bureau of Labor Statistics, OES, Nurse Practitioners, http://www.bls.gov/oes/current/oes291171.htm
- Bureau of Labor Statistics, OES, Physician Assistant, http://www.bls.gov/oes/current/oes291071.htm
- Bureau of Labor Statistics, OOH, Nurse Anesthetists, Nurse Midwives, and Nurse Practitioners, http://www.bls.gov/ooh/healthcare/nurse-anesthetists-nurse-midwives-and-nurse-practitioners.htm
- Bureau of Labor Statistics, OOH, Physician Assistant, http://www.bls.gov/ooh/healthcare/physician-assistants.htm
- JAMA Internal Medicine, Burnout and Satisfaction With Work-Life Balance Among US Physicians Relative to the General US Population, http://archinte.jamanetwork.com/article.aspx?articleid=1351351
- National Commission on Certification of Physician Assistants: https://www.nccpa.net/
- NCCPA, http://www.nccpa.net
- PAEA, Program Directory, http://directory.paeaonline.org/
- Projections Central, projectionscentral.com