Nurse Practitioner (NP) vs. Physician Associate or Assistant (PA)

Pursuing a clinical healthcare career isn’t limited to becoming an RN or doctor. Clinical healthcare professionals with bachelor’s degrees can become nurse practitioners or physician assistants and provide patient care with master’s degrees which students can complete in two to three years. Both positions are primary care providers who offer general or specialized healthcare in clinical or hospital settings. 

Why consider a career as a nurse practitioner or a physician associate (formerly known as a physician assistant)? 

First, these positions require fewer years of education and clinical experience than physicians. Medical doctors spend approximately eight years in medical school and fellowships after completing their bachelor’s degrees. By comparison, NPs and PAs can meet master’s degrees and clinical requirements in two to three years. 

Second, NPs and PAs are compensated very well and have infinite potential for growth to expand into other practice areas. Lastly, a national physician shortage in the United States means 21,000 to 55,000 primary care providers will be needed in 2023. NPs and PAs can provide clinical services that fill gaps and expand Americans’ access to medical care.  

Nurse practitioners (NPs) are classified as advanced practice registered nurses (APRNs), and the extent to which they can see patients and prescribe medicine depends on state practice autonomy laws. Some states allow NPs full practice authority, while others limit prescribing power and may require NPs to work under the guidance of a physician. NPs can specialize in family care, nurse-midwifery, psychiatric-mental health, or other areas. Most NP graduate programs require two years of coursework and clinical experience. 

Physician associates/assistants (PAs) work alongside doctors and independently practicing clinicians to provide comprehensive patient care in all areas, including diagnostics management, treatment planning, education, chronic disease prevention, family planning, and more. Most PA master’s programs require 27 months or three academic years of studying and hours of clinical rotations to be eligible for certification. 

Healthcare is one of the fastest-growing employment sectors in the United States, poised to grow 13 percent in the coming decade. The US Bureau of Labor Statistics (BLS 2022) showed that two million new healthcare positions will be created between 2021 and 2031, including nurse practitioners (NPs) and physician associates (PAs). Notably, during that decade, nurse practitioners occupy the fastest-growing profession in the country, with an expected 46 percent growth in openings nationally. Positions for physician associates are projected to swell 28 percent. Both figures are well above the 5 percent average growth anticipated among all jobs nationally.

Read on to learn more about nurse practitioners versus physician associates, including career outlook, salary data, educational programs, and professional certification for both professions.

How Much Do NPs and PAs Make?

With two to three years of graduate school and clinical hours, NPs and PAs can earn lucrative salaries that are more than double the national average for all occupations, which is $58,260 (BLS May 2021). 

Here is the median annual salary data for NPs and PAs, including salary percentiles and the top-paying employers.  

Nurse Practitioner Salaries

The mean annual wage for the 234,690 nurse practitioners in the U.S. was $118,040 with the following percentiles (BLS May 2021):

• 10th percentile: $79,470
• 25th percentile: $99,540
• 50th percentile (median): $120,680
• 75th percentile: $129,680
• 90th percentile: $163,350

Physician Assistant / Associate Salaries

The mean annual wage for the 132,940 physician assistants in the U.S. was $119,460 with the following percentiles (BLS May 2021):

• 10th percentile: $77,940
• 25th percentile: $99,880
• 50th percentile (median): $121,530
• 75th percentile: $131,740
• 90th percentile: $164,620

The BLS shows that most NPs and PAs work full-time during regular business hours. However, it’s worth mentioning that NPs and PAs may have on-call shifts or be expected to work irregular hours in specialized clinics, for example, OB/GYN offices.

Licensure & Certification: NPs and PAs

State and professional organizations highly regulate primary care providers. For example, most states require NPs and PAs to graduate from accredited master’s degree programs, pass state-level licensure examples, and earn certification credentials to work legally. 

Read on for details on how nurse practitioners and physician associates can pursue licensure and certification after completing an NP or DNP (doctorate of nursing practice) degree program. 

Nurse Practitioner Licensure & Certification

To become an APRN in most states, an aspiring NP must: 

• Have a registered nursing (RN) license
• Complete an accredited graduate-level master’s (MSN) or doctoral (DNP) program 
• Achieve national certification in a specialty (e.g., family health, pediatrics, women’s health, psychiatric-mental health, etc.)
• Complete all state-level requirements

MSN and DNP programs are accredited by the Accreditation Commission for Education in Nursing (ACEN) and the Commission on Collegiate Nursing Education (CCNE). Most of these requirements vary by state, and aspiring nurses should research which certification might be required by the state or territory where they intend to work. 

Physician Assistant / Associate Licensure & Certification

To gain admission to PA programs and earn state licensure, aspiring students must meet specific requirements:

• Bachelor’s degree in a hard science
• Previous patient care experience (working as an EMT, paramedic, or nurse can fulfill this requirement for admission)
• Earn a master’s degree from an accredited program 
• Pass the Physician Assistant National Certifying Examination (PANCE)

Nearly 300 PA programs are accredited by the Accreditation Review Commission on Education for the Physician Assistant, Inc. Once a PA passes the PANCE exam, they earn the Physician Assistant-Certified (PA-C) credential.