Compare NP vs. PA: What Path Will You Choose?
How do NP vs. PA career paths stack up against each other? Either one is a great option if you want to lead care, but you don’t necessarily want to spend a decade in medical school. Nurse practitioners (NPs) and Physician Assistants (PAs) are sometimes called mid-level providers, and while they can share similar scopes of practice, their education and career tracks are very different.
An NP is an advanced practice registered nurse (APRN) who often specializes in a specific clinical area, such as psychiatry, pediatrics, or midwifery. A PA is a licensed clinician who has gone through training that’s similar to medical school. This allows them to work in multiple specialties throughout their career, with more physician collaboration.
When considering the difference between a nurse practitioner and a physician assistant, it’s important to note that the specific scope of practice for both NPs and PAs is heavily influenced by state regulations — different states, different rules.
Why do the differences between NPs and PAs matter? Depending on your situation, one track may be significantly easier to pursue than the other, so you can start working faster in the specialty area you desire. This article is your backstage pass to the contrasting worlds of NP vs. PA career tracks, exploring the ins and outs of their responsibilities, education routes, salaries, and outlooks, so you can make the right choice for your life.
NP vs. PA: Job Description
What Is a Nurse Practitioner?
An NP is a registered nurse who has completed advanced education and clinical training to provide a wide range of healthcare services, including health promotion, disease prevention, and diagnosis and management of acute and chronic health conditions.
In full practice authority states, NPs can practice with a greater degree of independence. They may be able to diagnose, treat, and manage patients without direct supervision from a physician.
What Is a Physician Assistant?
A PA is a healthcare professional who practices medicine as part of a collaborative team with physicians and others. Versatility is a hallmark of the PA profession. They go through medical-school-like training with clinical rotations in various specialties, including emergency medicine, internal medicine, family medicine, and general surgery. This makes them well-versed in a variety of areas, and allows them to transition between different specialties throughout their careers.
PAs practice medicine under the supervision of a licensed physician. The level of supervision can vary, but PAs generally work in collaboration with physicians, without the option to practice independently.
Do Responsibilities Differ Between NPs and PAs?
Both of these roles have changed significantly over the last several decades, as healthcare has grown more complex and patients require a higher level of care. Their job responsibilities are further shaped by the specific policies of healthcare institutions and states where they practice. NPs and PAs share many responsibilities, yet each brings unique contributions to patient care.
Nurse Practitioner vs. Physician Assistant: Shared Responsibilities
- Patient assessments, including medical history, physical examinations, and diagnostic evaluations.
- Diagnosis and treatment of common medical conditions, which may include prescribing medications and formulating treatment plans under the guidelines and regulations of their respective scopes of practice.
- Collaboration with other healthcare team members — including physicians, nurses, and allied health professionals — to provide coordinated and comprehensive patient care.
- Prescriptive authority, including controlled substances. In some states, NPs can prescribe medications independently. PAs can prescribe medications, but the extent of their prescriptive authority may depend on state regulations and the collaborating physician’s preferences.
- Patient education regarding preventive care, health maintenance, and management of chronic conditions to promote overall well-being.
Nurse Practitioner Responsibilities
- Holistic patient care: NPs often emphasize a holistic approach to patient care, considering not only the physical health but also the mental, emotional, and social well-being of the patient.
- Health promotion and education: NPs emphasize health promotion and disease prevention, focusing on educating patients about lifestyle changes that result in better health.
- Specialization: NPs often specialize in specific types of nursing, such as:
- Primary care: NPs often serve as primary care providers, managing routine healthcare needs, performing physical examinations, and coordinating patient care over time.
Physician Assistant Responsibilities
- Diagnostic and therapeutic procedures: PAs may perform a range of diagnostic and therapeutic procedures, such as suturing, casting, and assisting in surgery, under the supervision of a physician.
- Emergency medicine: Many PAs work in emergency medicine, managing acute medical conditions and making critical decisions in high-pressure situations.
- Pre- and post-operative care: PAs often assist in surgical procedures, providing pre-operative and post-operative care and collaborating closely with surgeons and other members of the surgical team.
NP vs. PA Education Requirements
The educational paths for a nurse practitioner vs. physician assistant follow different trajectories — nurse practitioners start with nursing education and progress to specialized master’s or doctoral programs, while physician assistants pursue specialized training resembling medical school.
Steps to Becoming an NP
If you don’t yet have an RN license, it takes at least six to eight years to become a nurse practitioner. This path includes a combination of education and experience requirements. The steps to become an NP include the following educational milestones:
1. Get a Bachelor’s Degree in Nursing
The first step is to complete a Bachelor of Science in Nursing (BSN) program, which typically takes about four years. This program provides the foundational knowledge and skills needed for nursing practice. Some students earn an Associate Degree in Nursing (ADN), and attend a bridge program afterward.
2. Obtain Nursing Licensure
After completing the nursing program, pass the National Council Licensure Examination for Registered Nurses (NCLEX-RN) to get a nursing license. Learn more about the next generation of the NCLEX.
3. Gain Clinical Experience
Most NP programs require applicants to have clinical experience as an RN. The amount of required experience varies by program but is often around one to two years. Consider these specialties to build strong clinical skills:
4. Choose a Specialization
Nurse practitioners often specialize in areas like pediatrics, women’s health, acute care, or psychiatric-mental health. Choose an NP specialization that aligns with your goals. If you prefer a broader focus, consider family nurse practitioner programs.
5. Pursue a Graduate-Level Program
Choose an accredited graduate-level program in nursing that offers a specialty program in the area you want to practice as an NP. Some programs lead to a master’s degree, while others lead to a doctoral degree, which is becoming the standard for NP education.
6. Obtain NP Licensure
After completing your NP program you’ll need to apply for state licensure as an advanced practice registered nurse and pass the exam. Keep in mind that to practice independently as an NP, the required clinical experience differs from state to state.
Steps to Becoming a PA
Thinking about becoming a PA instead of an NP? The educational path to make it happen is different, especially if you’re looking to make the switch from RN to PA. Here are the steps to take to become a PA:
1. Earn a Bachelor’s Degree
While some PA programs accept students with an associate degree, a bachelor’s degree is typically preferred. The degree can be in any field, but it’s common for students to major in biological sciences, healthcare, or a related field.
2. Complete Prerequisite Requirements
Most PA programs have specific coursework and experience requirements, and gaining admission can be very challenging. Common prerequisites include biology, chemistry, anatomy, physiology, and statistics. They may also require applicants to have hands-on patient care experience. This can include work as an emergency medical technician (EMT), paramedic, medical assistant, nurse, or other healthcare roles.
3. Complete a PA Program
Successfully complete a PA program, which typically takes around two to three years. PA programs include both classroom instruction and clinical rotations. Coursework covers medical sciences, patient assessment, pharmacology, and clinical medicine.
4. Complete Clinical Rotations
PA students undergo supervised clinical rotations — often 2,000 hours or more — in various medical specialties, gaining practical experience in areas like internal medicine, surgery, pediatrics, emergency medicine, and more.
5. Obtain PA Licensure
After completing a PA program, graduates must take and pass the Physician Assistant National Certifying Exam (PANCE), a national certification exam. Success on this exam is required for licensure.
How Long Does It Take to Become a PA vs. NP?
The overall time to become an NP, including nursing education and advanced practice preparation, usually ranges from six to eight years. In contrast, the journey to become a PA, with all its steps, may take around six to seven years.
PA vs. NP Salary Averages
The average nurse practitioner salary is $132,000 annually, while the average physician assistant salary is higher, at $136,900.
Top 5 highest paying states for NPs:
Top 5 highest paying states for PAs:
- California
- Washington
- Oregon
- New York
- New Jersey
Comparing Job Outlook for NPs and PAs
The job outlook looks promising for both professions. Overall employment for NPs is projected to grow 46% in the next decade. The job growth for PAs is expected to grow 28% in the same time frame — both significantly faster than the 3% expected growth for all occupations.
NP vs. PA: Which Track Is Right for You?
The day-to-day rhythm of a clinician in either one of these roles can be very similar. Many facilities will hire either an NP or PA for the same job. But if you’re contemplating which track is best, there are several differences to take into account. See our table below for an at-a-glance comparison.
| Category | Nurse Practitioner (NP) | Physician Assistant (PA) |
|---|---|---|
| Education | NPs earn a bachelor’s degree in nursing to start as RNs, then earn an MSN or DNP. | PAs complete a bachelor’s in a science-related field, then a master’s degree in Physician Assistant Studies. Entry to PA programs is very competitive. |
| Education Cost |
BSN: $40,000-$200,000+ MSN: $30,000-$100,000+ DNP: $21,318-$38,912 for post-master’s, $40,953–$74,752 for post-bachelor’s. |
Bachelor’s degree in a health field: $108,584-$182,832 Master’s degree in PA studies: $95,165-$103,660 |
| Training Focus | Nursing model — holistic, patient-centered care emphasizing prevention, education, and wellness. | Medical model — disease-centered care emphasizing diagnosis, treatment, and pathology. |
| Experience Requirement |
500–750 hours |
2,000+ hours |
| Licensing and Certification | Licensed by state boards of nursing; national certification required (e.g., AANP, ANCC). | Licensed by state medical boards; certified by NCCPA (National Commission on Certification of Physician Assistants). |
| Scope of Practice | Varies by state; in many states, NPs can practice independently and prescribe medications without physician oversight. | Typically work under physician supervision or collaboration, though autonomy varies by state and employer. |
| Specialization Options | Choose a population focus (e.g., family, pediatric, acute care, psychiatric-mental health, women’s health). | Generalist training allows flexibility to switch specialties without additional certification. |
| Time to Practice | 6–8 years total. | 6–7 years total. |
| Salary Average | ~$132,000 | ~$136,900. |
| Ideal For | Nurses who value patient relationships, education, and holistic care. | Those interested in a medical, diagnostic focus and working closely with physicians. |
Why You Might Want One Track Over the Other
Depending on your situation, one track might make more sense than the other:
| Why to Become an NP | Why to Become a PA |
|---|---|
| You already have an RN license.
You want to focus on a specific patient population or illness. You may want the option to assess, diagnose, and prescribe independently. You want to work during school. |
You have a non-nursing, but health-focused, bachelor’s degree.
You want the ability to work in multiple specialties throughout your career. You want to work under the supervision of a physician. You have a strong GPA from previous schoolwork. |
NP vs. PA: What’s Your Next Job?
Now that you know the difference between these two roles, it’s time to embark on the job search. IntelyCare can help you to build a career you want. Sign up today and discover personalized nursing opportunities that cater to your specific needs.