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PA vs MD: Roles, Responsibilities, And Key Differences

March 9, 2022
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IntroductionWhat Is a PA?What Is an MD?PA vs. MD: PhilosophyPA vs. MD: Application and EducationPA vs. MD: Career Outlook and SalaryWhich Is Better? How to Choose Between PA and MDFAQs: PA vs. MDPA vs. MD: The Choice Is Yours

Most medical patients can't tell the difference between a PA and MD. Can you tell the difference between a PA vs. MD? Read on to learn how the two careers are similar and where they diverge.

Going to medical school gives you the opportunity to have choices as you forge your way into the world of medicine. With the right training, you can choose to become a physician assistant (PA) or a doctor of medicine (MD). You’ll be working with patients and bettering lives in the community no matter what route you choose. 

Although they are both highly collaborative roles that have considerable overlap in their duties, they are incredibly distinct. So, what is the difference between PA and MD? How do you become one, and which is better? If you’re switching from MD to PA and back again in your mind, we’ll walk you through how to choose between PA and MD.

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What Is a PA?

A PA is a versatile licensed medical professional educated in the medical model who collaborates with physicians to examine, diagnose, and treat patients. PAs have diverse roles and responsibilities.

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What Is an MD?

An MD is a licensed medical professional who practices allopathic medicine. They receive thorough training in various specialized medical fields, including pediatrics, psychiatry, surgery, and radiology. 

PA vs. MD: Philosophy

PAs, like MDs, are educated in the medical model. Dawn Morton-Rias, president and CEO of the National Commission on Certification of Physician Assistants, states the “foremost responsibility” of a PA, “like physicians, is to diagnose, treat and manage” patients.

Morton-Rias claims that, once licensed, PAs provide 80 to 90 percent of the services ordinarily provided by physicians. Indeed, a study conducted by the Annals of Internal Medicine determined that there were no significant variations in the care and treatment of diabetes by PAs and Mds.

However, one difference between PA vs Dr is that PAs are not independent practitioners. Each state regulates the PA scope of practice differently, though all PAs must work under the supervision and delegation of an MD.

In contrast, physicians can perform all of the duties PAs can. They maintain independent medical practices, perform surgeries, and prescribe medications. Unlike PAs, they have full liability over their patients and act as the most responsible provider.  

Additionally, when patients have complex cases, other differences between the two careers emerge. Morton-Rias notes that “on the rare occasion where the patient has a very complex or unique situation or condition presenting unusually, then we consult with physicians on care and management of that patient.”

PA vs. MD: Application and Education

Both MD and PA career routes are incredibly competitive. They start with a postgraduate college degree, and  good grades are essential.

Requirements

While entry requirements vary between schools, most PA schools desire a 3.5 minimum GPA in non-science classes and a 3.47 minimum GPA in science classes. Most applicants major in a science-based field as some of the PA school prereqs are fulfilled by the coursework. 

Although not always required for your undergraduate degree, you may need to take standard classes like:

If these topics aren’t covered in your undergraduate program, you may need to take more courses to fulfill these requirements. Thankfully, the MCAT is optional as most PA schools don’t require it. But prospective PAs are expected to take the GRE and achieve a minimum score of 310.

One of the unique prerequisites for PA schools is the 2,000 hours of healthcare experience. Although not required for all programs, having them makes you a more competitive applicant.

Gaining hands-on experience with patients can be achieved over two to three years of part-time work during your undergraduate degree or one year of full-time employment. 

Unfortunately, assisting with ailing family members and shadowing physicians won’t cut it — the school admissions boards look for paid healthcare experience. However, several fields accepted for these 2,000 hours include: 

For medical school, more rigorous academic requirements need to be met. A minimum GPA of 3.78 in your non-science classes and 3.64 in your science classes for an overall 3.71 GPA is essential for a competitive application. Although you can major in any field, certain prereqs need to be met. The coursework required for many medical schools includes:

Though the amount of required healthcare experience for MD school is far lower than the prerequisite for PA school, having as much hands-on exposure to the world of medicine as possible makes you a more competitive applicant.

In addition, while the GRE is optional, prospective MDs have to take the MCAT. Although some medical schools set minimum scores and others don’t, the average MCAT score that most MD applicants achieve is 511.

Cost 

Though fees depend on the school’s location, the institution itself, and access to in-state tuition, the annual tuition fees of PA programs range from $30,000 to over $120,000

Medical school, however, costs significantly more, and tuition rates are increasing. Costs depend on the school’s location, whether it is a public or private institution, and in-state tuition availability. The average tuition fee is $41,000. 

Course Structure 

PA schooling can take anywhere from 12 months to three years, though most courses range from two to three years to complete. Compared to medical school, PA schooling is more generalized. 

The first year of PA school aims to provide you with a firm grounding in various topics such as medical ethics, clinical medicine, human anatomy, and pharmacology. One advantage of this more generalized curriculum is that studying multiple specialties offers PAs the flexibility to work in more than one specialty during their career.

For MD students, the first two years are spent taking courses such as biochemistry, anatomy, medical ethics, and pharmacology. Practical skills like examining patients, diagnosing illnesses, and taking medical histories are also gained during this period. 

During the later years in both programs, there is a strong focus on clinical rotations completed within hospitals and clinics under experienced medical professionals’ supervision. 

PAs spend more than 2,000 hours doing clinical rotations in different areas of medicine, providing them with a broad base of practical knowledge. Clinical rotations offer students cross-functional knowledge that can be used when dealing with various emergencies and more general instances in their daily practice.

One secret to thriving during your rotation, says Dr. Bernard Leo Remakes, is to “completely immerse yourself in the rotation as though you planned to specialize in the rotation’s discipline.” 

Post-Education and Licensure

Once PAs have graduated from one of the 267 PA programs accredited by the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA), they can begin their careers. To do so, they must obtain a state license after passing the Physician Assistant National Certifying Exam

Although there are options to pursue additional training, Ann Marie Strong, a Family Medicine Physician Assistant in Minneapolis, says that “most PAs round out their skills with on-the-job training” instead of undertaking “optional residencies.” 

For physicians, however, further education is required. Almost all graduates enter a postgraduate residency training program catering to their preferred specialty.  This is one of the requirements for obtaining a medical license. 

These residencies tend to last between three and seven years, depending on the specialty. The National Resident Matching Program’s Main Residency Match, better known as “The Match,” is the most widely used system that allocates medical students a spot in a US residency program. 

MDs must then pass all three steps of the US Medical Licensing Examination (USMLE) to become board-certified and obtain a state license. Those seeking to pursue a highly specialized area of medicine need to do a fellowship. Both professions require periodic recertification and continuing education throughout their careers. 

PA vs. MD Lifestyle and Practice

“So you finish medical school, residency, and become a full-fledged practicing doctor. You are ready for a good night’s sleep. Forget about it,” jokes Dr. Alex Roher, a certified anesthetist. “Modern working arrangements,” Roher says, have created “the ‘week of nights,’ where you work four or five and sometimes seven night shifts in a row.” 

Although some PAs work more than 40 hours per week, they typically have a somewhat consistent 9 to 5 work schedule. MDs, on the other hand, often work long, irregular, and overnight hours. The Physicians Foundation’s Physician Survey found that most physicians work an average of 51.5 hours a week, with almost 1 in 4 working 61- to 80-hour weeks. Additionally, both professionals can be on call, meaning they must respond to work queries and emergencies with little notice.  

Unfortunately, both careers can be physically and emotionally demanding. Dissatisfaction, depression, and burnout are common in physicians and one Medscape survey reported that 42 percent of a sample of 115,000 physicians in 29 specialties experienced high-stress levels and burnout.

For PAs, this figure stands at a slightly lower 32.6 percent, according to the AAPA. “Typically, the PA lifestyle — it’s a little less stressful because there’s a little less responsibility involved, less schooling obviously,” says Joshua Johnson, a Hawaii-based PA who focuses on orthopedic surgery.

PA vs. MD: Career Outlook and Salary

Being a PA is one of the fastest-growing professions in the country. The Bureau of Labor Statistics (BLS) estimates that in the next 10 years, the number of PAs is expected to increase from 118,800 to 155,700, approximately 31 percent. 

The demand for PAs is so high that three-quarters of graduates receive multiple job offers at graduation. While not as high as the demand for PAs, the overall need for physicians and surgeons is anticipated to grow by 4 percent in the next 10 years. Certain specialties like psychiatry are projected to expand by 12 percent. 

“Once you have your PA license, that basically affords you an opportunity to work in any medical specialty,” says Hanifin. Having this level of professional mid-career flexibility, Hanifin continues, means PAs can transfer between certain specialities without getting additional training. Data from four decades analyzed by the AAPA indicates that 49 percent of PAs changed their specialty at least once throughout their time practicing. 

However, while physicians have more opportunities to specialize during their training, changing specialties once they begin practicing is challenging. Few doctors opt for this route.  The cost and time of the retraining required and the likelihood of the need to do another specialized residency are enormous. 

While physicians don’t have the same mid-career flexibility PAs do, their education and postgraduate residency specialization mean that they can work independently and run their businesses.

Salary 

Salaries for PA vs Dr. professions depend on several factors, including their specialization, the location of their practice, and whether they work in a private practice, hospital, or clinic. The BLS reports that PAs earn an average annual salary of $108,610.

On the other hand, MDs generally earn higher wages than PAs. The BLS has stated that the median salary of MDs was more significant than or equal to $208,000. According to the BLS, most MDs are family and general doctors who earn an average wage of $211,780. 

Of course, the wages of MDs are dependent upon their specialization. The average annual salaries for anesthesiologists, surgeons, and psychiatrists are $261,730, $252,040, and $220,430, respectively. However, one annual survey found that plastic surgeons can earn over $500,000 in one year alone. 

Which Is Better? How to Choose Between PA and MD

Table comparing pay, career outlook, and responsibilities of PAs and MDs

Hanifin says the main factors that influence a student’s decision to attend PA school are the ability to begin a career more quickly combined with the length of PA programs and the smaller debt burden. 

Echoing this sentiment, Dr. Will Kirby, a dermatologist and the chief medical officer for the LaserAway aesthetic dermatology group, argues that this mid-career flexibility is an advantage of being a PA instead of a MD. If your work-life balance needs a change, Kirby states:

“a PA who starts out in a kinetic field in his or her early 20s, like emergency medicine, for example, may decide that they want to start a family and that a slower-paced, more predictable field suits them better in their early 30s and can transition over to dermatology with very little effort.”

On the other hand, becoming an MD has its advantages. If money is a motivating factor, MDs generally receive higher annual wages than PAs, primarily if you pursue a lucrative specialty like plastic surgery. 

For Dr. Strong, her love and enjoyment of the science of medicine led her to “the more in-depth training of medical school and residency.” Additionally, the varied, dynamic, and autonomous nature of a career as an MD is a handsome prospect. Unlike PAs, who are not independent practitioners, MDs can work independently. They can run their own practices, and receive a higher degree of financial compensation while doing it. 

Dr. Sylvie Stacy, a Bessemer-based Preventive Medicine Physician, also says that MDs have a more comprehensive range of work options. “Especially in medical or healthcare-related, non-clinical jobs, such as working for a pharmaceutical company or health insurance company” and organizations looking for medical leadership, she continues, MDs are highly sought after. 

Ultimately, for those who are deciding between PA vs MD, Sobel suggests, “should consider shadowing both types of healthcare providers” and speak with those who are in each profession. The combination of asking professional real-time questions and having hands-on experiences with both careers will uncover how “the pros and cons of each profession will resonate differently with every individual.”

FAQs: PA vs. MD

Still have questions about which career path is right for you? Check out our most frequently asked questions, answered. 

1. Do I need to take the MCAT to get into a PA program? 

In short, no. Currently, there are no PA programs that require you to take the MCAT specifically. However, most PA schools do ask you to take the GRE instead. 

2. Where do PAs work?

Like MDs, PAs work in various healthcare settings, including nursing homes, community health centers, medical offices, hospitals, educational facilities, workplace clinics, correctional institutions, and retail clinics. Additionally, PAs work for federal government agencies and serve in the military. 

3. Is it possible for a PA to become an MD? 

“Can a PA become an MD?” The answer is yes, although the road to becoming a licensed MD is a long one. However, it is not impossible. You’ll need to attend and fund your way through four years of medical school, a postgraduate residency training program, and a fellowship and then sit the USMLE to become licensed. 

4.How does the work/life balance of an MD compare with a PA? 

If you’re wondering if you should become a PA or MD, work/life balance is a main influencer. Though both occupations work on-call, PAs have many roles and responsibilities, but often have a more structured 9 to 5 schedule than MDs. High stress and burnout are experienced in both, though data shows that a higher percentage of MDs suffer from burnout than PAs. Ultimately, both occupations are extremely physically and emotionally demanding. 

5.How much clinical experience do I need to become a PA?

Most PA schools require you to have 2,000 hours of hands-on healthcare experience under your belt. Many prospective PA students are former medical assistants, paramedics, and nurses who have accumulated these hours over their respective careers. 

6.Can MDs re-specialize?

Yes, although the MD would have to complete another postgraduate residency training program. Then you would have to procure a fellowship in the relevant specialty and then sit the USMLE to become licensed in that field. 

7. Why do a PA instead of MD?

If you’re considering why you should do a PA instead of MD, think of what you want most out of your career. If money is your main motivator, an MD is the clear choice. However, if you want a better work/life balance and more consistent hours, PA may be the better choice.

PA vs. MD: The Choice Is Yours

“Should I become a PA or an MD?” It’s a difficult question and one that only you can answer.

If you are looking to perform clinical tasks independently, earn a large sum of money, and run your own practice, become an MD. However, if you are not sure where your medical future lies, consider becoming a PA. The mid-career flexibility combined with the slightly less stressful work/life balance is an attractive prospect for many. 

Ultimately, when deciding between PA vs MD, your decision depends on you, your motivations, and your future ambitions.



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