NP vs. PA

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If you are considering an advanced degree in healthcare, you may want to know the difference between the nurse practitioner (NP) and physician assistant (PA) occupations. The truth is these two careers are similar in some ways, and different in others. Both provide career alternatives to professionals who wish to work in advanced healthcare but not as physicians.

On a very basic level, an NP attends a nursing school while a PA attends a medical school or center of medicine. Nurses follow a patient-centered model, in which they focus on disease prevention and health education and handle assessment, diagnosis and treatment. Physician assistants follow a disease-centered model, in which they focus on the biologic and pathologic components of health, and also practice assessment, diagnosis, and treatment. NPs can specialize in several areas, including adult-gerontology/geriatrics, mental health, pediatrics and women’s health. PAs have more of a generalized education, but can also specialize in areas like emergency medicine, orthopedics and general surgery. When thinking through the similarities and differences between physician assistants and nurse practitioners, keep in mind the different health care philosophies, educational options and available specializations to determine which might be the best fit for you.

Side-by-Side Comparison

Below is a side-by-side comparison detailing nurse practitioner and physician assistant job preparation and training, on-the-job frameworks, and pay and career outlook. Both NPs and PAs should play important and growing roles in health care, given the U.S. could see a shortage of 100,000 physicians by 2030, according to the American Association of Medical Colleges. Additional NPs and PAs will almost surely need to step in to fill vital health care roles.

Nurse Practitioner Physician Assistant
Number practicing in the U.S. 166,280 as of 2017, according to the Bureau of Labor Statistics (BLS). 109,220 as of 2017, according to the BLS.
Pay The mean annual wage, as of May 2017, was $107,480, or $51.68 per hour for NPs, according to the BLS. The mean annual wage for PAs, as of May 2017, was $104,760, or $50.37 per hour, the BLS reports.
Expected job growth 36 percent from 2016 to 2026, much faster than the average for all occupations (7 percent), according to the BLS (2018). 37 percent from 2016 to 2026, much faster than average.
Anticipated number of new positions available by 2026 56,100 39,600
Meeting the Requirements
Degree requirements Currently, NPs need a minimum of a master’s degree from an accredited school to become licensed within a state. Even though the American Association of Colleges of Nursing (AACN) recommended that the new NP standard be the doctor of nursing practice (DNP) by 2015, states and credentialing entities still just require a master’s degree. PAs need a minimum of a master’s degree from an accredited medical school or center of medicine to seek licensure.
Degrees available An NP can seek a master’s or DNP from a nursing school, although the DNP is suggested by the AACN. More than 200 physician assistant programs, most of which were master’s degrees, were available in 2017, according to the BLS.
Program details NPs typically choose a specialty area and need to complete 500 didactic hours and between 500 to 700 clinical hours (1,000 for DNPs). PAs are trained as generalists and typically need to complete about 1,000 didactic hours and more than 2,000 clinical hours.
School accreditation NP programs typically will be accredited through the Commission on Collegiate Nursing Education (CCNE) or the Accreditation Commission for Education in Nursing, Inc. (ACEN). PA programs are accredited through the Accreditation Review Commission on Education for the Physician Assistant, Inc. (ARC-PA). A list of PA programs is made available through the Physician Assistant Education Association (PAEA).
Certification and Licensing
Certification NPs can seek national certification in their specialty area through the American Nurses Credentialing Center (ANCC) or the American Academy of Nurse Practitioners. PAs need to pass the Physician Assistant National Certifying Examination (PANCE) available through the National Commission on Certification of Physician Assistants (NCCPA).
Licensing An RN license, a master’s (MSN) or doctoral (DNP) degree, and national certification are generally needed to seek state licensure. A master’s degree from an accredited school and national certification are generally needed to seek state licensure.
Licensing Agency NPs seek licensure through a state board of nursing or board of medical examiners. The AACN provides links to the licensing agencies. PAs seek licensure through a state medical board, board of medical examiners or similar. A list of state licensing agencies available through the National Commission on Certification of Physician Assistants (NCCPA).
Re-certification NPs must be re-certified every five years or less, depending on their population focus and credentialing entity. They may sit for the appropriate exam or complete a minimum 1,000 hours of clinical practice and 75 to 150 continuing education units in their NP specialty. PAs need 100 hours of continuing medical education (CME) hours every two years and an exam every six years.
Details about the Job
Practice Framework NPs generally work with physician oversight. However, NP practice authority varies by state and in some states NPs have been granted full practice authority (FPA). View state-by-state NP practice authority status. PAs cannot work independently of physicians, although similar to NPs, there’s a growing movement toward independent PA practice authority.