By Elizabeth LaScala, PhD
While PAs and MDs do similar things in their day-to-day work, there are many differences that may make a PA pathway more suited to certain individuals. Of these many differences, I’ve identified four main factors that will help you decide if a PA program may be a better fit than medical school.
Post-Degree Requirements
After completing your PA program, you’ll need a national certification and a state-issued license in order to practice as a PA.
Certification: First, you’ll need to pass the PA National Certifying Examination (PANCE). This is a five-hour test with 300 multiple-choice questions covering medical and surgical material. If you don’t pass, you can retake the exam once in a 90-day period or three times a year (whichever is fewer) for a maximum of six times within six years of graduating.
State licensure: You’ll then need to apply for licensure. Each state has their own requirements. Many states, including California and New Jersey, require you to be co-signed to a physician who will supervise your work.
Maintenance: You’ll need to maintain your license by completing 100 hours of continuing medical education credits every two years and passing the Physician Assistant National Recertifying Exam (PANRE) every ten years.
Hands-on experience
The PA path is ideal for those who appreciate hands-on experience. This is true even during the application process—PA applicants are expected to have completed more hands-on hours than those applying to medical school. Since PAs will go on to be supervised and trained on the job by a physician, this emphasis on learning by doing will be maintained throughout your career. If hands-on experience gives you more satisfaction that learning in an academic setting, the PA path may be for you.
Investment and payout
Becoming an MD is a big investment of your time. MDs complete a 4-year Doctor of Medicine followed by three or more years of medical residency. PAs, however, receive their degrees through a master’s program in two to three years. Once this is complete and they have obtained a license, they can practice as PAs without completing a residency.
Becoming an MD is also a big investment of your money—MDs will pay $200,000 – $300,000 for their education while PAs will pay $70,000 – $90,000. However, the resulting salary for these two degrees is similarly disparate. According to the US Bureau of Labor Statistics, the median PA salary was $121,530 in 2021 while the median MD salary was $208,000.
For some applicants, the promised payout makes the investment in medical school worthwhile. Others might prefer to join the workforce as soon as possible, regardless of the pay, or they may balk at the idea of accumulating excessive student debt. This tradeoff is important to factor into your decision.
Preferred work/life mode
The most fundamental difference between the nature of working as an MD versus a PA is independence. MDs are medical professionals licensed to diagnose and treat patients independently while PAs must work under supervision of a doctor. As such, PAs have limits to what they are able to do on their own. These limits are defined at a state level. Here’s a great interactive guide on PA Scope of Practice Law that gives an overview of how variable state-level laws can be.
How do you feel about being supervised? Is it irritating? Or do you feel more comfortable working closely with someone else to achieve a goal?
Since PAs don’t need to shoulder the burdens associated with independence (like running your private practice), they can opt to work a 40-hour week instead of the 60+ hours many physicians dedicate to their practice. If you place a high value on things outside of your medical career, being a PA is a way to practice medicine with a lower risk of burnout.
Generalist or specialist
MDs and PAs can both work as generalists and specialists. Physicians become specialists by continuing their formal training in a specific medical discipline, like surgery or pediatrics. This usually means completing additional years of training and even completing a specialist residency. These specialties tend to be compensated according to how advanced the skills are and the amount of time taken to train. PAs can also specialize by practicing and training under a specialist. Because this training takes place on the job, PAs are unlikely to see that same jump in compensation. However, since it isn’t as costly or time consuming for a PA to specialize, it’s easier to shift to a new specialty. The amount of time and effort MDs spend on their specialties locks them into their chosen niche more tightly.
Post-Degree Requirements
After completing your PA program, you’ll need a national certification and a state-issued license in order to practice as a PA.
Certification: First, you’ll need to pass the PA National Certifying Examination (PANCE). This is a five-hour test with 300 multiple-choice questions covering medical and surgical material. If you don’t pass, you can retake the exam once in a 90-day period or three times a year (whichever is fewer) for a maximum of six times within six years of graduating.
State licensure: You’ll then need to apply for licensure. Each state has their own requirements. Many states, including California and New Jersey, require you to be co-signed to a physician who will supervise your work.
Maintenance: You’ll need to maintain your license by completing 100 hours of continuing medical education credits every two years and passing the Physician Assistant National Recertifying Exam (PANRE) every ten years.
