PA vs NP: Salary Comparison

Posted By: Kubin   |   Salary and Jobs

We get the question all the time about PA vs NP salary comparison.  So we decided to answer in some detail.

It’s a great question, but it’s hard to find good data on NP salaries because the Bureau of Labor Statistics, where NP salaries are tracked, lumps them in with the salaries of regular nurses.  This is because NPs are Advanced Practice Nurses, meaning they are nurses who have had extra training to allow them to do more.  So we did some digging and the result is our new PA vs NP salary comparison page.  Think of us as the Consumer Reports of PA vs NP salary information.

We hope that seeing accurate numbers for the PA vs NP salary comparison will leave you with a better understanding of both professions.

PA vs NP Salary Comparison – All Specialties

According to the National Salary Report 2010 (a survey of 4,256 PAs and NPs by Advanceweb for PAs and NPs), PAs consistently earn a little more than NPs.  Here are the numbers.  (Click the table to enlarge):

Pa vs np salary comparison 2001-2010
PAs have always in made slightly more than NPs.

Why do PAs earn more?  No one is certain, it likely relates to gender bias.  NPs start as nurses, and traditionally nursing has been a largely female profession (it still is by a factor of 4 to 1).

pa vs np salary comparison male vs female
Even within each discipline, women earn less.

The first PAs, on the other hand, were armed forces medics who returned from the Vietnam war and found themselves overqualified for nursing and medical assisting, but unqualified to be physicians.  To utilize their war-honed skills, they were trained to provide an expanded scope of practice closer to what they had known in battle.  Being soldiers, the first PAs were all male.  Today there are plenty of male nurses and female PAs, but the ratio for PAs vs NPs is quite different.  How much does this relate?   Just look at the numbers:

You’re probably aware that there are other factors that affect NP vs PA salary.  Here are the numbers by specialty, ranked from highest to lowest in each discipline: pa vs np salary by specialtyWe were a little surprised.  Mental health is a money specialty?  Maybe because it gets fewer takers than the “sexier” specialties, like ER.  We will definitely be doing a piece on  and mental health as a PA specialty in the near future.  We also found it interesting that Emergency Medicine is the highest paying specialty for NPs, but not for PAs (mental health, schools, cardiology, and dermatology come first for PAs).

You can also see that PAs generally make a little more than NPs in all specialties – even women’s health, and at the top end this difference becomes more dramatic (116K for men in mental health, 100K for women).  We think it relates to gender bias — according to psychologist Matt Wallaert of GetRaised, “Not only are women less likely to make it to those upper ranges of a profession because of promotion gaps, “when they do get there they are less likely to be paid fairly.”**

So here’s our PA vs NP Salary Comparison Summary, which tells us a little more about both fields than just what they earn:

  • There are more women than men in both professions, but the ratio of women to men is much higher for NPs than for PAs (80% vs 45%).
  • Overall PA vs NP salary comparisons show differences of 5%-7% more for PAs than NPs.
  • Though there are more women than men in both fields, on average, men are paid 11-13% more than their female counterparts.
  • PA vs NP salary comparison shows that differences are highly influenced by a clinician’s specialty and work setting — possibly more than any other factor.  We didn’t research how the geographic location where the clinician practices influences the PA vs NP salary comparison here, but plain to in the future.

So there you have it.  Drop us a comment – we’d love to hear your thoughts.

**Forbes.com – The Best Paying Jobs for Women in 2011 by Jenna Goudreau

82 comments

  1. Quote “You can also see that PAs in the ER definitely make more than NPs. This salary difference is considerable, and may again reflect a gender bias toward men.”

    I see PA’s making ~103k and NP’s making ~104k according to your data, did I overlook something?

    VERY in depth and interesting article. I am very interested in the salary comparison data. I have a brother in law that is starting NP school about the same time I plan to start my PA Program and we have talked about the possibility of opening a rural health clinic together, I think I’ll be sharing this with him :) .

    Jeff

    1. Yes, thanks for catching that – it was from an earlier draft. We’ve made the change. Please let us know how your program goes…

    2. Debra Ricci says:

      Hi Paul. I know that your comments regarding NPs v. PAs has been awhile. I hope you don’t mind if I ask you a couple questions. I have been on LTD for three years. My medical condition is cervical spine issues. I am wanting to return to work after my surgeries but fear I may chose the wrong career, physically speaking. I am looking hard at Healthcare Administration and the PA programs. Since you are in the PA program yourself, maybe you wouldn’t mind describing the program to me. I have been in radiology for years but this job is so physically demanding and I can no longer do it. But on the other hand, I cannot sit at a desk all day long. Any surprises that you have learned about the program? How demanding is it? I am single and 41 y/o. Do you think that doing the PA program is to late to start at my age? Any information would be appreciated. Thank you for your time. Have a nice day. If you are still in the program….Good Luck!

      1. Debra – I don’t really think your age is a nonstarter. But your health could be. I’m not sure what your specific physical limitations are, but PA school is demanding, and you will be spending many hours at your desk studying. The physical demands of medicine vary by specialty – surgery is very hard on the body, ophthalmology or dermatology less so, and every variation in between. I see no reason that you shouldn’t test out the waters by taking a few classes while you recover, AS LONG AS DOING SO WON’T JEOPARDIZE YOUR RECOVERY IN ANY WAY. This means that if things get too intense, or the stress is harming you physically, YOU OWE IT TO YOURSELF TO STOP. Your health is priceless, and no career is worth risking it for. But as you take courses, you may also get more familiar with what you may experience as a PA, and you may develop some creative ways of coping with those demands. As for support: call on your friends and classmates. Emotional and social support are crucial while you’re in PA school, and I think when you’re out too. No one does it alone – I know I didn’t.

  2. Finally found a website that provides a salary comparison chart & with specialties. Thank You!

    1. Glad we had what you needed. Keep reading – maybe we’ll come up with something else that you find helpful!

  3. Paul,

    I have never been into blogs or forums much, but ever since I started having the internal debate of PA/MD school, I’ve done a lot of research. This might be my first post at any blog ever, but I would just like to give credit where it’s due. Your website and content has been MOST helpful! (a little Bill and Ted’s grammar there). The interviews are very informative, and the information is very helpful to students looking to decide which route they want to take. Keep up your good work!

  4. great post! i write about MD Salaries on my site and received a tweet asking about NP Salaries. i will direct them here. cheers.

    1. Thanks, Sam. Yes, I’m working on more specialties. Hopefully I’ll have an orthopod for you in the near future.

  6. Thank you so very much for this comparison. I have been comtemplating between going into either an NP or PA program, even though I was thinking more PA anyways, but this gives me a greater understanding of what the differences are, and has also given me some ideas of what department I would like to work in as well! Keep up the good work, I will look into some other topics that you have covered as well.

    1. Thanks for the compliment, pickles! Getting clear on which direction is right for you will reassure you that you made the right decision once you’ve made it. Nice to have you here. -P

  7. Benjaminian Assistant. What advice do you have for me? says:

    I am 59 years with masters degree in health sciences. I specialised in international health but now I want to train as a physician assistant. How do I proceed?
    Thanks
    Benjamin Offoha.

    1. Hi, Benjamin!

      First, I would suggest you order written information from one or more of the PA programs that interest you. This will give you some specific ideas about what PA programs look for in their candidates.

      Second, you might want to sign up for our free forum. You can find it at https://www.mypatraining.com/staging/forum. There’s plenty of information on specific topics there, and you can even add questions of your own.

      Glad to have you,

      Paul

  8. i just want to say i am in nursing school but i love your site and have signed up for future postings it really is interesting. My goal is eventually to be an NP but this is definitely shows me that I whats in me to become a PA and maybe changing my mind for grad school lol

    1. That’s great, Kenneth! There’s plenty of carryover from PA to NP, so you won’t be wasting your time. Who knows – maybe we’ll cater to the NPs someday!

  9. P – Thank you so much for all of your wonderful information. I graduate with my BSN in December (2012) and am looking forward to applying to BCM in Houston for the PA program. I would love to know if you know anything about the program there. Thanks for all of the vids and articles, I look forward to keeping in touch.

  10. The Veterans Administration pays NP’s over $15,000 more than PA’s for the same job.

    A similar situation existed in the past at Santa Clara County,CA
    This was challanged by a lawsuit and won by the PA’s involved.
    From that time on PA’s and NP were paid the same.

    Is there any such action on the Federal level?

  11. Hi Paul,

    I just wanted to say how much I appreciate this website – it is everything I was looking for to help me pursue my PA career.

    I was just curious about the specialty “primary or secondary schools”. What is the scope of practice for this specialty? I haven’t been able to find much information online and it being so highly compensated, I’m surprised I haven’t heard much about it.

    Thank you!

    1. Thanks, Lauren! I think that’s referring to one of the settings where PAs sometimes work – elementary, middle, and high schools. I’m not sure what capacity PAs work in in schools, but there must be a few out there – maybe in large, well funded schools?

      1. Thanks for the timely response Paul! I am surprised that the salary would be so high for these schools, there must be some other sort of funding. Interesting nonetheless!

        Good luck in your upcoming rotation!

  12. Hi I am a school teacher and I am interested in switching careers. I was wondering what are the pre-requsites for the PA program. I met a wonderful PA at a chiropractic center and was interested in wanting to know the steps that I should take.

    1. Hi, Patrice! Thanks for your question.

      Yes, there are academic prerequisites. They generally include a bachelor’s degree, and the following science as part of it, or in addition, in the case that you didn’t get them as part of your BA/BS:

      Human anatomy (1 semester, or one year if combined with physiology)
      Human physiology (1 semester, or one year if combined with anatomy)
      Organic chemistry (some programs don’t require it) (one year)
      Microbiology (one semester)

      The other courses are often part of a bachelors, such as 1 semester of human anthropology or evolution, english comp, basic math, etc.

      The OTHER big requirement, and possibly the harder (but not impossible) one for you to obtain as a teacher: health car experience. Program requirements vary between 500 and 4000 hours in contact with patients. This can be done as an EMT, phlebotomist, nurse, paramedic, physical therapist, respiratory tech, medical assistant, etc, and some are better than others. To learn more about it, I suggest you check out our forum: https://www.mypatraining.com/staging/forum, where there are many threads on the topic of this “HCE.”

      You should know that the field was intended to be a fast track for people who already have health care experience, so starting from square one can be challenging. But people definitely do it.

  13. What are your thoughts on PA for orthopaedic? And do you know what there salary is like? In addition what is your view on a school that requires only an Associates degree versus the Bachelors degree? I’ve done my research and both programs offer the same classes for P.A. school.

    1. Hi, Daniel! My opinion: go where ever you can get in. The only crucial thing is that you get your PA-C after you graduate, and to do that, any accredited PA program will do. If you have more than one to choose from, then you can consider other factors. If that becomes the case, I urge you to read the guest contribution by Buffchick on choosing the best physician assistant program for you. She is one of our readers and will be starting PA school this fall.

      Most orthopedic PAs make very good money, particularly if they work for a an orthopedic surgeon. For details, refer to our article on physician assistant salary.

      And welcome! -P

  14. Hello, I just wanted to say i love your artical it really gave me insite on pa’s an np’s. I am a cna with prequites for nursing school. Im just not sure if i should get my bsn first then apply to pa school or just apply now. I live in wa and the only pa school requires 4000 hours even as a cna. Will that be enough experence to quailfy for pa school or should i look into being a nurse first? Also, is having a masters degree in pa better than a ba? Thank you for your time.

    1. I don’t usually recommend becoming a nurse if what you want is to become a PA, since it could make the PA schools wonder why you didn’t go to nursing school. Not sure if I’m reading your second question right or not, but if you are wondering if it’s better to have a PA certificate or a Masters in PA medicine, the masters is better, but it won’t make much difference when you apply for jobs. In most cases, getting a job is more about your skills, experience, and personality than your prior degrees, since all you really need to become a PA (legally) is a certificate, not a masters.

  15. Great info!

    I am currently pursuing a Msc. Health Admin, and was considering adding a clinical dimension to my qualification… But, since I am not particularly keen on nursing, I have been seriously considering PA.

    Pretty helpful info you provided…

  16. This was very helpful!!! As I’m looking to switch careers, while only 23 and in the midst of college education and a full-time career as a manager at a call center. I have been very apprehensive about the potential in salary for my current job vs. the potential in salary for something in the medical profession (as I’ve now realized, this is something that catches my interest). This was comforting, thanks for the research! Keep up the good work :D

  19. I’m about to start my freshman year of college, and I’m looking into different careers so this article was super helpful! I have one question: would getting a bs in nursing and then getting medical experience as a nurse prepare me for admission to both a PA program and an NP program? I’m still not sure exactly what I want my career to be, but nursing at my school has a lot of requirements so I would have to declare my major almost immediately. I read in a comment above that nursing isn’t smart if you want to be a PA, and this makes me really uneasy. Thank you so much for your time!! :)

    1. Nursing can work for Pre-PA, but we don’t recommend it. If I were on a PA school adcom, I would prefer someone who did another major that they enjoyed to someone who did nursing. It makes it look like you intended to go into nursing, but either 1) are wishy-washy about it, and 2) you bailed because you didn’t want to do all the nursing work.

      Listen to our podcast on majors.

      1. Sarah Sharp says:

        hello,
        i have been an RN for 4 years, and have truly loved the work. i have been fully dedicated to nursing, and when looking into going back to school, the curriculum for PA was for more exciting to me than NP, for whatever reason. i have gotten flack from plenty of RN-NPs, who said i abandoned nursing. i prefer to say my nursing career will INFORM my PA career… why further your education if the direction doesn’t excite you? this makes me neither wishy-washy or a person who doesn’t want to do work. thems my two cents!!
        OH!! p.s. i only needed four pre-reqs in addition to my AAS in nursing to apply to my dream PA program… so it’s not a completely insane track to take!!

        1. Good for you! It takes guts to tell people what you want when they want something else for you. But they don’t need to live with the results – you do. Let us know how it goes…
          P

  20. Hi Paul,

    My daughter is starting her pre-nursing this fall 2012, with possibly getting into NP if she sticks the course. To me, NP and PA pre-requisites seem to be pretty much the same so maybe once she get her BSN she can decide. Can you give pro and con between NP and PA if possible? My understanding is that NP might have more flexibility to work pretty much any where, but PA has work under a doctor maybe in a clinic or a hospital (OR for example)- however PA seems to have more autonomy (don’t have to take order from MD like NP)

    1. Sure.

      They’re very similar, and in some states (California, for example), the differences in what they do is zero. The biggest difference? How they are educated. The NP curriculum is an extension of the nursing curriculum, with an emphasis that is more holistic, and that involves much patient education, prevention and health maintenance. NPs are nurses first – they are “advanced practice nurses,” or APNs. They may practice independently in some states just by hanging their own shingle, but due to liability, cost, and need for nearby higher medical care, etc., they almost never do.

      PAs, by contrast, are not nurses at all. Their mandate is to always practice under the license and supervision of a physician. For this reason, they are educated on a model that is more similar to medical school, with an emphasis on treatment of disease (although there is plenty about prevention and health maintenance too). Although they work “under” a doctor, in practice they may consult with that doctor little or lots, depending on 1) the PA’s experience and comfort with a particular diagnosis/situation, 2) the doctor’s faith in the PA, and the patient’s complexity. Experienced PAs handle exactly the same type of patients as physicians. In surgery, the doctor is almost always calling the shots (making the big decisions about how to handle care), and the PA assisting. But the PA still makes decisions on his or her own outside of the OR, such as when following up on the patient’s condition. They do procedures, and generally carry out the doc’s treatment plan, by being in charge of the details that make that plan up.

      Some hospitals prefer PAs to NPs, and the reverse is true as well – it just depends.

      NP PROs: they can in certain situations practice independently, they are preferred in women’s health settings (because they are 90% female, as opposed to PAs who are 65% female), they are intimately familiar with how hospital care his delivered because they usually have worked in a hospital as a nurse before becoming an NP. Their role is better understood than that of PAs on the whole. There are settings that are reimbursable for NPs that are not for PAs (see below).

      NP CONs: some doctors feel that their medicine is not as good as PAs (possibly because they have a bias about nurses), they are sometimes looked on the doctors and the public as glorified nurses (which they are not).

      PA PROs: they don’t need to have a BSN/MSN to go to PA school. Their pay is higher than NPs’ on average by a couple thousand dollars per year. Because they tend to work more closely with doctors, they may be exposed to more acute/serious/complicated medicine (though this is not always the case).

      PA CONs: the public is not so familiar with PAs as NPs. They have less understanding of nursing care of their patients because they haven’t delivered it themselves, they cannot practice independently (in theory). There are settings that are not reimbursable (yet) for PAs, such as delivering palliative care.

      I should emphasize that the PROs and CONs of the two fields offer minor distinctions between the two. I’ve met HIGHLY skilled and knowledgeable NPs and ding dong PAs, and vice versa. I think the care depends more on the person, and not the credential.

  21. I would think Getting my MSN compared to a bs in Bio would be more favorable because nursing school is a crash course in medicine. Wouldn’t the admission committee for PA school Find a nursing degree more desirable compared to a more academic undergrad degree? I received my RN (ADN) last year and also have many additional biology/chemistry classes and could get my bs in bio within one year but I feel like getting an MSN in nursing would make me a more desirable canadate and would take me less time (online msn) than finishing a bio degree. In nursing school I completed over 550 clinical hours. Also, they should know that because I already went to nursing school, PA school would be much easier for me than say someone with their undergrad in bio, right? I love the OR so becoming a surgical PA would make me very happy.

    1. I tend to think the only reason to get an MSN is because you hope to pursue nursing or NP. I think admissions committees think this way too. In fact, your progression might make more sense to them if you now pursued that “more academic undergrad degree.” The story might go something like this: you pursued nursing as far as it satisfied you, then decided to change course and bring all that you had learned to PA, which you found was a better fit. You have to remember that what you have done implies your plans, your intention. A nursing degree says, “I want/wanted to pursue nursing.” I’m not saying you can’t get into PA school with a nursing degree, but I generally discourage them – you don’t want the adcoms to think you are half baked about a career as a PA.

      1. Amy Warren says:

        I am a PA and many of my classmates were nurses prior. It is definitely not discouraged and oh will help you a lot.

  22. Paul,

    I’m entirely a different breed of health professional, very complicated and frustrating if you tend to ask more questions, such as: why I did that? why I didn’t do it? First of all, I’m married with three kids ( 2 in middle school and 1 HS). Second, I’m 43 years old and breadwinner in the family. Third, I’m a foreign-graduate nurse AND physician. I’m evenly mixed nurse-doctor. I came to America for a VERY personal reason (for my autistic kid). I’m working as a nurse with MSN degree finished last year. PA came to my mind because of my medical background but I wanted to ELEVATE myself financially and start working on DAY shifts because I’ve been a 40-hour night duty nurse for many years now. I got attracted to your column because of the PAY. That’s why I googled, “which pays better NP or PA?” You answered it by favoring PA. With all those backgrounds of mine, PA seems to be gender attractive to me because I’m male and the autonomy, too. My probable practice area will be Northeast starting from Virginia or probably California in the future because those where my relatives are. I love mental health and cardiology. The latter is CardioThoracic Surgery Unit now for 6 years. Your comparison shows that PA on Cardiology and Mental Health pays the highest. If I decided to go to PA, will they consider my medical degree abroad? The school that I graduated my medical degree qualifies us to take USMLE. In fact, many of my classmates are already doctors here. Probably, you’re about to ask me why I didn’t challenge USMLE. My math is 43 years old + 1 year of review for boards + 4-5 years of residency training (depending the specialty) = 47 years old + during these arduous training my kids and wife are still dependent on me. Is it worth going through these training to be a doctor? (provided if I pass all the tests). Or can I just settle now between PA vs NP? Please give me insight. Thank you very much.

    1. Hi, Margon – Yes, they will take your foreign medical degree into account. It won’t equal “skipping” any of the prerequisites, but it should make it clear that you have medical experience.

      Actually, I wasn’t going to ask why you didn’t challenge the USMLE; there’s more to a career as a physician than just passing the USMLE (Obviously you know that). But Whether you would be satisfied as a PA or not is a very personal question that I’m afraid I will need to leave up to you. Poke around our PA vs MD section and you may get a little help, but I think you’ll find I’m consistent: it’s a personal choice. I suppose a large part of the PA vs NP part might have a lot to do with if you will need to go to a US nursing school or not. To become an NP, you will need a bachelor’s degree in nursing. To become a PA, you just need a degree and to convince them that it’s in a relevant subject.

      Keep us posted.
      P

  23. THANK YOU! Finally a good source of information. Have you come across any statatics showing PA’s salary in relation to geography? I was also curious thinking further down the road. Let’s say I’ve been a PA for 10-15 years, do you see salaries reflecting the years of experience? What can I do to make more as a PA later down the road? Thank you for everything Paul!

    1. I don’t have geographic details for salary, but if you contact the AAPA, I’m sure they would. They even help you when you get out of PA school to determine what a particular type and location of job typically pays.

      PAs with years of experience make more than less experienced PAs, but the specialty and work setting also makes a big difference. A new ER or surgery PA might make the same as an experienced pediatric or primary care PA. My suggestion: figure out what you want to do, then look for settings in which that work pays best; the most important factor in any job should be how much you enjoy your work. When you find that, the money will follow you.

  24. What exactly is provisional accreditation? Would one still be eligible to sit for the Physician Assistant National Certifying Exam (Pance)?

  25. Ell coleman says:

    I have never been so ready 2 do smthng n my life…lol i was going 2 get my degree n nursing but then i came across the amazing paul article that shed sme light… i should get my bachelor in science and then pa school instead of my bsn n nursing then pa?

    1. Yes, if your goal is PA. Nursing school is a big, expensive detour that will make admissions committees question your commitment to becoming a PA.

  26. Thanks for the information about not approaching a BSN if your interested in becoming a PA. I have a Business Management Degree and was looking at a BSN as helping me get into PA school because of the knowlege I would bring with me. However, my concern after reading some of your articles is: what if I can’t get accepted to PA school? I see 800 plus applications with only 30 to 40 accepted. I’m 47 yrs old and have learned to keep options open. I was thinking of getting my BSN degree while applying for PA and if I did not get accepted then slide into a NP program. They seem to be a little easier to get in. What are your thoughts?

    Steve

    1. I guess my answer to this question is another question: how would you feel about a BSN if PA school didn’t work out? If it interests you, then, it’s not a bad idea. If you’re doing it to become a PA, I don’t recommend it. In your case, I suggest you apply to more schools (12+). It will cost you more, but it’s that many more opportunities to get noticed. Also, write an essay that capitalizes on your age and wisdom.

      “I will not make age an issue of this campaign. I am not going to exploit, for political purposes, my opponent’s youth and inexperience,” Ronald Reagan quipped during the 1984 presidential debates when asked if, at 73, he is too old to be President. The line — a classic example of Reagan’s sense of humor — even solicited a laugh from Democratic opponent Walter Mondale. (Never mind that Reagan continually mangled the facts during that election’s debates. The Republican actor-turned-statesman ended up winning by a landslide).

  27. I was curious as to what the average salaries for PAs fresh out of PA school looked like? Any ideas? Variances in specialties starting out?

    1. I don’t have any stats on that, but I can tell you there is a WIDE range, based on
      -geographic location
      -specialty
      -type of clinic
      -how impressive a new grad you are

  28. Hello Paul,
    This website is very informative, Thank you :) I currently have a BS, not related to this field of study, but seriously thinking about a career in becoming a Physician Assistant. Is there a difference in salary for a PA that has and associates degree and a PA that has a masters? Could I get my associates in the field and still gain the same knowledge and salary? Also, if I were to move to a different state to complete my PA degree, would I have to take the PA examination in my home state as well as the state I would get my degree in or can I graduate from one state and just take my test in my home state?

    1. Thanks, RJ.
      There isn’t a huge difference in salary for AA/AS vs BA/BS, and in some places none. Some employers pay attention to this, but most pay more for the responsibilities of the job, and these are identical, no matter your degree. I still STRONGLY advise you to get your bachelor’s because very soon it will be an absolute requirement for PA school, and it will make you a much better rounded person.

      Moving to a different state isn’t as hard as you might think. Your certification (what makes you a PA) is national. Once you pass it, you can go anywhere in the US without retesting. You will need to apply for an receive a license in the state where you will practice, and laws differ from state to state regarding cost of the license, renewal requirements, etc.

  29. Hi Paul,

    I am currently enrolled in nursing school, and I decided that nursing is not for me (I do not really like nursing theory all that much- I’m more interested in the science aspect of medicine). I intended to pursue the NP route, but I am seriously thinking about the PA route. This website has been really helpful with providing me with just about all of the information I need. I’m thinking about just finishing nursing school and then taking the remaining pre-reqs for PA school. I think you mentioned on here that having a nursing degree might make the PA admissions people question a person’s committment to PA school. Should I switch degrees or finish nursing?

  30. Hi Paul
    Great site. Quick question about my experience. I’m a licensed therapist and I’ve got roughly 6-7000 hours of patient care combined in methadone treatment, outpatient psychiatry, and private practice therapy. Even though it’s not hospital or medical clinic based, will the experience be considered? I’m hoping to go into the psych specialty, so my counseling experience is certainly helpful, but do you think the experience would be weighted differently if I intended to go into another specialty (I also like family and peds.) Thanks for your input

    1. Some schools will count it, and others won’t. You should describe your work with an emphasis on medical/psychiatric aspects. Did you help make DSMIV diagnoses? What have you learned about medication, addiction, and mental health.

      So yes, they may count it. But I would say you have more than enough of this type of HCE than you need. What you need is more traditional forms of HCE, such as work in a hospital, ambulance, or medical clinic. I wouldn’t spend another minute where you are – 6-7000 hours is plenty. Now work on what you lack. ALWAYS PUT YOUR TIME AND ENERGY INTO YOUR APPLICATIONS’S WEAKNESSES. Seal them off like holes in a dyke. Think “water tight.”

  31. Paul –
    Thank you for this website. I have been a critical care RN (bachelor’s degree-trained) for 14 years and am currently a flight nurse in the Rocky Mountain Region. I love what I do, but I am 45 years old and do think of the long-term risks of continuing to fly, especially since I have young children. I am considering obtaining my Master’s degree in either a PA or NP program. I like the idea of the autonomy that an NP enjoys versus a PA, but there is soooooo much BS in nursing master’s programs that have absolutely no relevance to what you actually do after you graduate. Plus, nurse practitioners earn horrible salaries in our geographical area…..typically less that an RN on an hourly basis! Go figure. Even though I am a “male nurse”, I still am very proud of my profession and what we do. But I am very torn which way to proceed. I do know that I want to continue to focus on the care of critically ill patients. Suggestions?

    1. That’s a tough one. I assume you have a pretty clear idea about what NPs, PAs, and critical care nurses do.

      Have you looked in to becoming a nurse anesthetist? They make excellent salaries (pretty much anywhere, go figure), make important decisions, and must be well-experienced nurses. Sounds like these aspects might interest you. It would probably be harder to transition to P/A (though definitely possible).

      1. Yes, am conisdering that route as well. However, it would be very difficult to continue to work to support my family even on a part time basis in a CRNA program. Plus there are not any programs in my area and I am not particularly interested in relocating. But it is something to definitely mull over. Thank you for your input!

  32. I have an ADN degree. I’m getting my BSN online which only offers pass fail grades. I’m also taking some preq science classes at a local university. I have one yr experience as a home health visiting nurse. Do you think I stand a good chance of getting accepted into a PA program? It’s my dream to become a PA

    1. Hi, Nadia. It’s very hard to say – there are just so many factors. Make yourself the best candidate you possibly can with good grades, as much HCE in several settings as you can get, and solid letters of recommendation. Then let them decide.

  33. Paul,
    I’m in a crazy situation. I graduated with a BS in Biology(Cell Physiology) Minor in Chemistry in December 2012. I applied to 6 PA school and unfortunately wasn’t selected by any of them. I also applied (at the time as a back up) to a Direct Entry MSN Program (RN-MSN). I got accepted quite late to the MSN Program and it starts in 10 days. I’m currently planning on and all set up to go to the MSN Program but I thought you’d be the perfect person to talk to about my inner worries. I had a 3.041 cum and around a 2.75 science. I called some of the pa schools I applied to and they said it’d be tough to get in if I did reapply; I’d have to retake courses and do much better on the GRE. I’m terrified if I go through this MSN Program and STILL want to be a PA at the end of it…but I honestly think I’d be happy in both careers. It would be a lot of work to eventually get into PA school whereas I do have this opportunity to become a NP right in front of me and I could work part time as an RN once I receive that licensure. I’m in a huge time crunch and just wanted to know your thoughts. My dad is a Urologist and has given me some solid advice but I’m looking for more. Also, do you know anything about Direct Entry MSN Programs?

    I really appreciate your time!

    1. I’m sorry – I don’t know much about direct entry programs.

      I think it might be worth it to stay in your program as planned. 1) guaranteed training and degree, 2) pretty much a guaranteed job, 3) a chance to bring some relevant coursework to the table, and 4) you will then be able to apply to BOTH PA and NP programs. This last one seems particularly important in light of the feedback you received. You may not end up going the PA route, but I think it is close enough the NP that you might find it just as satisfying.

      My only other advice to you: kick ass in nursing school/grad school. You never know what you might want to do with those grades, but you will have many more options before you if you excel in your program. If you do poorly (or even just okay), you can cross of PA school, and maybe NP school as well.

      Sometimes a bird in the hand really is worth two in the bush, you know?

  34. Yes, I’m guessing they are referring to nonpublic schools – boarding schools or schools for trouble with emotional problems. This would almost certainly be mental health work, but honestly, this is the first I’ve heard of it. And primary schools? There may be one or two elementary school PAs, out there, but don’t count on doing that – if it exists, it’s exceedingly rare.

  35. Hi Paul,
    Thank you so much for your informational site. I am in a difficult situation. I was dismissed from my current pharmacy school because I had some extenuating circumstances and personal issues I was dealing with that unfortunately caused some of my grades to suffer, I left with a “C” gpa and am considering a career change if I do not decide to reapply for admission into my former or a different pharmacy school. I think I realized that I also did not do well in pharmacy because I lost my passion for it, having to memorize so much information that I questioned if I would even use in the future and the fact that the Job market for Pharmacists right now is so saturated was also discouraging.

    I have been doing a lot of soul searching and looking into a career as a NP or PA instead, because I am more interested in patient health care, rather than meeting sales goals by corporate retail pharmacies. I’m am planning on taking the GRE and applying to either NP or PA programs but was wondering if you think my past will cause admissions committees to automatically rule out my application or if it will set me apart in a positive way in that I have learned from some past struggles and am more determined and motivated than ever. By the way I am almost 25 and have no direct patient experience because I went to pharm school straight from undergrad.

    Thanks so much in advance

    1. You will definitely need health care experience. That’s an absolute requirement for most schools.

      I wouldn’t say that they would automatically do anything. But your GPA is the best predictor of how you will do academically in PA school. If you plan to apply, you will need to convince them that there are other factors on which they should focus. Your essay can be used to give them context for your grades. If you want to go to PA school, I won’t sugar coat it – you have work to do. You will need to retake the science courses in which you got weak grades. You need health care experience. You need a terrific essay.

      Think of it this way: what is the incentive for them to accept an applicant who has previously dropped out of a health degree program due to low grades and who has no experience working with patients?

      If you really want to do this, you may be able to, but you will need to put in some long hard hours improving your application.

      But again, if you really want to do this, don’t let what’s before you stand in the way.

  36. I am planning to attend a PA program in a couple years. Working hard to churn out good grades in my science pre-req’s. Regarding the requirements for prior health care experience, is there a generally good way to go about this? I do not work in the medical field now, so getting some experience would help fulfill that requirement as well as (hopefully) reinforce my desires. I’m just curious if there is a better line of health care to get that experience with. Any recommendations would be appreciated. Thanks in advance.

  37. Insightful article.

    Quick question – would community practice (i.e. community clinics) fall under family practice in your data?

  38. Hi Paul,
    I have a few quick questions. I’m currently a junior in high school am debating between being a PA and NP. Which program is more rigorous? Also, is there only a certain number of spots for each program? If i decide to choose the PA route, which undergrad major would be most recommended? if i dont get accepted to a PA program, what options do I have? Thank you!

    1. “Rigorous” is a pretty vague term. I would say that PA programs use the medical school model (studying disease and treatment), while NP school is more ecological (studying health, wellness, community intervention, prevention, etc.). But to become an NP you need first to become a nurse. To become a PA you don’t, which in my mind makes it a more attractive option. Yes, programs are limited in their class size, and there is great competition to get in for this reason. Class sizes vary from school to school depending on their budget. If you don’t get into PA school your options are about what they were before you applied: you can reapply, work on your application and THEN reapply, abandon the PA path and become something else, or sit around and whine. I recommend option #1 or #2.

  39. Hi,im an RN since 2009 in a skilled nursing facility,i have home health and dialysis experience. I like my job and my patients would say” you should be a doctor”… it is actually my dream to become one but it was too expensive to go to medical school in my country so i settled for dentistry instead ,i studied nursing in my country and decided to pursue nursing here in america coz as a foreign dentist,im required to study for two years and it costs more than 100thousand dollars per year! I dnt have that much and i cant get a loan since i havnt established my credit then thats why i pursue my nursing career.Now im thinking of getting a PA degree and someday be a full pledged medical doctor. Do you think its a good idea? I was told that my BSN wont be counted since i took it in my country thats why im not interested in pursuing NP.honestly i wanted a shorter route coz i want to get done faster and work like a doctor. going thru the NP route seems longer. Wht do u think?np or pa???

    1. No, I don’t encourage you to become a PA if you are really doing it to one day become a doctor. It’s a ton of work and although you will learn plenty of medicine, it won’t help you much in getting into medical school.

      Go to PA school because you want more than anything to become a PA. If you want to become a doctor, you should apply to medical school.

  40. Hi Paul
    I do not want to come off as arrogant or rude in any way. This is a serious concern that I have as a physician. I work in inner city area in a large hospital where I am exposed to many midlevel providers. It’s my experience that NPs in general are far less educated than PAs. Even in comparing NP to PA curriculum, the difference is obvious. PA school is quite competitive to get into, while NP schools are fairly easy to get into. And some even offered online! That is absurd and dangerous to me! I would never trust someone who learned their diagnosing skills online. Many PA schools are taught by physicians and students matriculate with medical students while NP students are taught by other nurses. I don’t understand how people find these two career comparable. PA far exceeds NP.

    1. Anna – this is not an uncommon concern. While there is probably more aggressive medical model education in PA school, NP students have the benefit of (usually) way more clinical experience than PA students (or medical students, for that matter). I’ve met some amazing NP students, however, and I think the factor that is actually more important, is what kind of a person and student they are. I’ve seen some in good schools who don’t work that hard and seek out knowledge, and others who work their butts off and have a true love of learning.

  41. Hi Paul,
    I am currently a junior in high school and know that I want to be a PA. Unfortunately, my grades have recently dipped and I know that I wont be accepted into any direct-entry programs. I want to know if it is possible to go directly from college to pa school. If I worked every summer and even during each school year to gain HCE, do you think they would accept that? Because of certain situations, I know that I can only spend so much time on my education. Any advice would be highly appreciated. Thanks in advance!

    1. Yes, it’s possible, but unlikely. To get into PA school, you need 500-2000+ hours of healthcare experience. This means that when you graduate, if you haven’t been spending lots of time working on that, you won’t be admitted. But if you have, what are the chances of having the GREAT grades that any PA school would want to see to admit you 5 years earlier than everyone else (the average age of starting PA school is 27).

      I recommend that you take just a little bit more time. As I’m always saying around here between the tortoise and hare, the tortoise always wins.

  42. Hi paul,

    I finally want to be a PA.
    Do I need any bachelors degree and how long does the PA Program take?

    1. Strictly speaking no, an associates is enough for about 5% of PA programs. The other 95% require a bachelors, since those will give you a masters when you complete it. I HIGHLY HIGHLY HIGHLY recommend you get your bachelors. A BA/BS is a minimum educational requirement country with a high standard of living like the US. It will also make you a more interesting and better informed person.
      Most PA programs are somewhere around 30 months. The shortest I know of is 20 months, and some are 36. Think 2-1/2 years for most.

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