Physician Assistant vs Nurse Practitioner

Physician Assistants and Nurse Practitioners serve similar purposes in medical settings. Learn about differences in their training and approach to patient care.

"What is the difference between a PA and an NP?" It's a question our admission team hears often. Students considering an advanced career in healthcare but who don't want to go to medical school often turn to physician assistant studies or advanced practice registered nursing programs instead. But what are the fundamental differences between these two similar careers?

Training Models

One of the biggest differences between the PA and NP professions is the training model from which the students learn. Physician assistants train using the medical model, similar to physicians, which means they focus on the testing, diagnosis, and treatment of the disease that the patient has. Nurse practitioners train on the nursing model, which means they focus on the testing, diagnosis, and treatment of the patient with the disease.

While the outcomes of the two training models are similar, philosophically they are very different. As an NP, you will look at how the illness affects the quality of the patient’s life. You will focus on health promotion and restoration and consider how individual patients, families, and communities react to the illness based on factors such as racial, ethnic, and cultural beliefs or socioeconomic status. Nurses look to how the treatment plan can be implemented in a way that values individuals and families preferences and beliefs. PA’s tend to look first at the pathology of the problem and then how to cure it. Looking for disruptions in the pathophysiology of the body, a PA focuses on the biologic aspects of diagnosing and treating the disease.

Areas of Specialty

PAs and NPs can both be found working in hospitals, clinics, and physician's offices. While they can fill similar roles within any given setting, one of the main differences is in how they come to their practice specialty.

PAs train as generalists, which means that after graduation they can practice in almost any field within medicine. This general medicine focus means that PAs can switch specialties throughout their career without the need for re-certification. Some PA’s attend post-graduate PA residency programs and specialize, but most receive on the job training to fill in any gaps in their general medical knowledge. Some specialties that are popular with PAs are emergency medicine, surgery, or orthopedics.

In the MCPHS Master of Physician Assistant Studies program, you will complete clinical clerkships in general medicine, pediatrics, psychiatry, surgery, emergency medicine, women's health, and two elective rotations. During these supervised clerkships, completed at healthcare institutions throughout Boston and New England, you will apply and reinforce the clinical and patient management skills you have learned in the classroom and labs prior to your clerkships.

Conversely, NP programs include a concentration on a specific patient population. Areas of specialty could include acute care, adult, family, gerontology, neonatal, oncology, pediatric, or women's health. At MCPHS, our NP programs specialize in Family Practice or Psychiatric Mental Health. The programs, which are offered online, allow busy RNs to pursue advanced practice while continuing to work. Additionally, you will be able to pursue clinical experiences in your own community.

Certification and Practice

NPs earn a primary certification in their area of specialty. NPs can seek independent prescriptive authority at the state level, which means they can treat and prescribe independently without the supervision of a physician. Though Massachusetts is currently one of 13 states that fully restricts NP's practice, many states are moving toward allowing full independent practice.

PAs takes a general certification exam called the Physician Assistant National Certifying Exam (PANCE). PAs, however, generally work under the supervision of a licensed physician. The topic of independent practice is a hot one in the PA world with organizations such as the American Academy of PAs (AAPA) advocating for the elimination of unnecessary supervision requirements in order to better serve patients, especially in underserved areas.

Both PAs and NPs need to be licensed at the state level and participate in continuing education in order to maintain their credentials. The most recent cohort of MCPHS-Boston PA students earned a 100% pass rate on the PANCE and our NP students continually score at or above the national average on their respective boards.

The salary and job outlook for both professions is also very similar. According to the U.S. Bureau of Labor Statistics, the PA profession is expected to grow 31.3% through 2029, and the median annual salary is $112,260. The NP profession sees equally strong numbers with an expected growth of 52.4% through 2029 and a median annual salary of $109,820. According to the U.S. News and World Report, PAs are ranked the #1 Best Healthcare Job, with NPs ranking right behind at #2.