Reviewed by:
Third-Year Medical Student, Lewis Katz School of Medicine at Temple University
Reviewed: 10/16/23
Most medical patients can't tell the difference between a PA and MD, but can you? Read on to learn how these two careers are similar and where they diverge.
Attending medical school allows you to have choices as you forge your way into the medical field. With the right training, you can 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’re both highly collaborative roles with considerable overlap in their duties, they’re incredibly distinct. So, what’s the difference between them? How do you become one, and which is better? If you’re switching from MD to PA and back again, we’ll walk you through how to choose between PA and MD.
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.
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.
There are many differences between PAs and MDs: let’s start with 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 - 90% of the services ordinarily provided by physicians. A study by the Annals of Internal Medicine determined there were no significant variations in the care and treatment of diabetes by PAs and MDs.
However, one difference between PAs vs Drs is that PAs aren’t independent practitioners. Each state regulates the PA scope of practice differently, though all PAs must work under the supervision of an MD.
In contrast, physicians can perform all the duties PAs can. They maintain independent medical practices. Unlike PAs, they have full liability over their patients.
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.”
Both MD and PA career routes are competitive. Here’s what you need to know:
While requirements vary between schools, some PA schools may have GPA cutoffs between 2.75 - 3.2, along with science-based course requirements. Most applicants major in a science-based field to fulfill course requirements.
Although not always required for your undergraduate degree, you may need to take classes like physics, statistics, and ethics. If these topics aren’t covered in your major, you may need to take more electives in these areas. Prospective PAs also need to take the GRE.
One of the unique prerequisites for PA schools is the hours of healthcare experience. Some programs may require 1,000 hours, whereas others ask for 2,000 – it depends on the program. Although not required for all programs, gaining hands-on experience with patients can help you become a more competitive applicant.
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 hours include:
For medical school, more rigorous academic requirements need to be met. A minimum GPA may need to be met for entry, but the average matriculant GPA is 3.62. Although you can major in any field, certain prereqs need to be met. The coursework required for many medical schools includes:
Though the required healthcare experience for med school is often far lower than for PAs, having hands-on medical-related experience makes you a more competitive applicant. Instead of the GRE, prospective MDs must 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.
Though fees depend on the school and location, the total tuition costs of PA programs range from $30,000 to over $120,000.
Medical school costs significantly more, and tuition rates are increasing. Costs depend on the school’s location and other factors. The average tuition fee is $41,000.
PA school can take anywhere from 12 months to three years to complete, though most courses range from two to three years. Compared to medical school, PA school is more generalized.
The first year provides you with a firm grounding in various topics such as:
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:
Practical skills like examining patients, diagnosing illnesses, and taking medical histories are also gained during this period. During the later years of both programs, there’s a strong focus on clinical rotations completed within hospitals/clinics under experienced medical professionals’ supervision.
PAs spend more than 2,000 hours doing clinical rotations in medical areas, providing them with a broad base of practical knowledge. Rotations offer students cross-functional knowledge that can be used when dealing with various emergencies and 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.”
Once PAs graduate from an accredited PA school, they can begin their careers. To do so, they must obtain a state license after passing the Physician Assistant National Certifying Exam (PANCE).
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 residency 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 U.S. 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 must do a fellowship. Both professions require periodic recertification and continuing education throughout their careers.
“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.”
The MD vs PA lifestyle varies. Although some PAs work more than 40 hours per week, they typically have a somewhat consistent 9-to-5 schedule. On the other hand, MDs 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 emergencies with little notice.
Unfortunately, both careers can be physically and emotionally demanding. Dr. Arun Saini, an assistant professor in the Division of Critical Care Medicine at the University of Tennessee Health Science Center, states that “dissatisfaction, depression, and burnout are common in physicians.”
One Medscape survey reported that 42% 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.
A physician assistant’s job outlook is excellent! The Bureau of Labor Statistics (BLS) estimates that in the next ten years, the employment rate of PAs will grow by 28%, much faster than the average of all occupations.
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 3% in the same period (slower than the average of all occupations).
“Once you have your PA license, that basically affords you an opportunity to work in any medical specialty,” says Hanifin. Having this level of mid-career flexibility, Hanifin continues, means PAs can transfer between specialties without additional training.
Data from four decades analyzed by the AAPA indicates that 49% of PAs changed their specialty at least once throughout their practice. However, while physicians have more opportunities to specialize during their training, changing specialties is challenging. The cost and time of retraining are enormous.
While physicians don’t have the same mid-career flexibility PAs do, their education and residency mean they can work independently.
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 $126,010.
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 $229,300. According to the BLS, most MDs are family and general doctors who earn an average wage of $224,460.
Of course, the wages of MDs are dependent upon their specialization. The average annual salaries for anesthesiologists, surgeons, and psychiatrists are $302,970, $347,870, and $247,350, respectively. However, one annual survey found that plastic surgeons can earn over $500,000 in one year alone.
Hanifin says the main factors influencing 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 this mid-career flexibility is an advantage of being a PA. 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 wages than PAs, primarily if they pursue a 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.” The varied, dynamic, and autonomous nature of a career as an MD is a handsome prospect; MDs can work independently. They can run their own practices and receive higher 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.
For those deciding between PA vs MD, Sobel suggests “considering shadowing both types of healthcare providers” and speaking with those in each profession. Asking real-time questions and having hands-on experiences with both careers uncovers how “the pros and cons of each profession will resonate differently with every individual.”
Still have questions about the differences between PAs and MDs? Check out our most frequently asked questions!
This is one difference between PAs and MDs; no PA programs require you to take the MCAT. However, most PA schools require the GRE instead.
Like MDs, PAs work in various healthcare settings, including:
PAs can also work for federal government agencies and serve in the military.
The answer to whether a PA can become an MD is yes, although the road is a long one. However, it’s possible. You’ll need to attend four years of medical school, a residency program, and then sit the USMLE to become licensed.
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 schedule.
Most PA schools require hands-on healthcare experience. Many prospective PA students are former medical assistants, paramedics, and nurses who have accumulated these hours over their careers.
Yes, you’d have to complete another residency program.
If you’re considering why you should do a PA instead of an MD, think of what you want most out of your career. If money is your main motivator, an MD is a clear choice. However, if you want a better work/life balance and more consistent hours, PA may be the better choice.
While both are certainly not easy routes, physician assistants typically spend much less time in school (12 months to three years), while MDs must complete medical school and a residency (a minimum of seven years).
Physician assistants aren't doctors.
“Should I become a PA or an MD?” It’s a difficult question and one that only you can answer.
If you’re looking to perform clinical tasks independently, earn a large sum of money, and run your own practice, become an MD.
However, if you’re unsure 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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