Pros and Cons of being a Physician Assistant


I received an email from someone considering the PA profession. The person was wondering about PAs and NPs and the pros and cons of being a PA. I sent him a reply and I am adding it here.
While you are here take this short survey. It will open in a pop up and close when you are finished. Just click on the “Take Our Survey” below.

I have enjoyed being a PA and find these items to be the PROs:

  • the pay has progressed from so-so to excellent
  • acceptance and understanding of the profession is very good and has made being a PA very pleasant
  • the working conditions are great and you get to work with the best and the brightest most of the time
  • the work is challenging everyday, although some of it is routine, the responsibility never is
  • I get thanked for what I do much more than 10% of the time
  • I am delegated as much responsibility as I can accept. I have worked in clinical medicine my entire career
  • there is great flexibility in what a PA can do. It is generally no hard to find a place to work if you choose to relocate. American PAs are sought after in Great Britain

The CONs

  • I have to get at least 50 hours of CME a year. You can get junk but high quality is expensive and time-consuming
  • You will never be “independent”. Even if you own the practice – you have to hire a doctor to be the supervisor and medical administrator
  • Your skills should be as good as an M.D. but you will always be paid less.
  • You have to take and pass a National Certifying Exam every 6 years.
Categories : Pre-PA HS, Pre-PA Univ


  1. Nick says:

    Yes that does help. Yes I like to learn as much as I possibly can. That is why I want to move up to a higher level of medicine. I sort of feel like I’m on cruise control now at work that is another reason I want to challenge myself. I will look into the program you suggested. Thanks for the fast reply.

  2. william loy says:


    I wanted to thank you for taking the time to speak with me over the phone the other day regarding my pending PA application. I would definitely recommend you and your site to anyone who is considering entering this field. You have a wealth of experience that people can draw from and the fact that you are willing to make yourself available to people like me in order to assist them only adds to the utility of this site.

    I will keep you posted as I continue to take my first steps down the “PA path”.



  3. Bruce says:

    David, My pleasure to be of service. Thanks for being part of the “Getting Accepted” program on the PA Path

  4. Umida says:

    Bruce, hi! Thank you very much for such a detailed and swift answer. I think I should follow ur advice and make some shadowing job. Besides, I still have questions i.e. since I’ll be applying to BS in PA as a freshman, don’t think will be accepted to it right away and first have to finish prereq courses. As far as I understood it will take me two years before I even can apply for PA program, right? Another question is, do I have to take those prereq courses at the same college I’ll be futher doing my PA program or they can be taken anywhere else? Bruce, you have mentioned several colleges in NY. What do you think about Sunny downstate medical school? I’ve registered for their information session on September 14th. Another thing I’m not quite aware of is how long is the program in total including 2 years of time required to complete prerequisite classes? Let’s say if the program is 4 years, then what’s next? Internship? How long will it take me to start working as a PA? Once I get my license in NY do I have to work only in NY or it’ll be good within the US? Regarding ur 20- week course, I think I’ll take it once I’ve started taking the prerequisite classes. Thank you, once again, for your suggestions……

  5. Umida says:

    Btw, the reason I’m asking about sunny downstate is its all campuses are in Brooklyn, and I live in Brooklyn.

  6. Jessie says:

    Wow, i’ve been trying to look for someone to answer my questions regarding me becoming a Physician’s Assistant. I’m in High School and I want my major to be PA. Can i go directly to MASTERS? or Do i have to finish my Bachelors first? What are some information and tactics you can give me to succeed well in college? Thank you so much!!!

  7. Bruce says:

    Jessie, There are 3 types of programs for civilians. (the military has its own top 25 program) The associates degree, the BS degree and masters degree programs. If I know I want to be a PA, I would select a 5 year program that gets me a BS in 3 and a masters in 2 more all in the same place. Most of those programs are in PA and NY. Some are state programs and some are private. You have a steep learning curve post PA program as all it does is get you qualified to receive a license, then the real learning begins.

  8. Urijah says:

    Hi Bruce, your website is great and your responses are even better. I have been an RN for 3 years in PICU but I am not interested in becoming an NP, however, the PA profession appeals to me. I have worked with both great NPs and great PAs. I recently relocated to California (seems like more of a nurse friendly state). What is your stance on RNs who opt to go the PA route versus the NP route? I have read on PA forums, which I have since stopped reading due to the increased negativity, that it would be a waste of time and money when NP school is an option.

    Thank you in advance!

  9. Bruce says:

    your problem I think, will be that you qualify for NP school with your current education and you might need 2-3 semesters more to qualify for PA school. After 5 years I don’t see a lot of difference between PA’s and NP’s in the ERs where I have worked. You get a masters either way and most NP programs are going to the PhD. here is the blog http://www.mypatraining.com to some fellows in PA school at UC Davis. They also have an NP track there and I think they take similar courses. Good luck on what ever you decide.

  10. Lauren says:

    I am currently a Pre-Med student, I am preparing for my MCAT in April and have already picked what schools I would love to go to. However, I am now starting to doubt if whether medical school is for me. I know that the medical profession couldn’t be a better fit, I just worry that as a doctor I won’t have the home life I want. My question for you is how much time does a PA put in at the hospital or work place compared to a doctor?

  11. ANNA says:

    Bruce, I have read the above statement in which you indicate that after 5 years, you dont see much of difference between PA’s and NP’s in the ER’s. Aforementioned, I would like to get your opinion on the salary. From a RN, would it be wiser to go straight to NP (since you are well familiar with the job)? or try an pursue a career in PA (and still get the almost-same pay with more liability)? I read about the pro’s and con’s and frankly, I’m stressing out about it.

  12. Bruce says:

    If you are an RN already, going to a really great NP course is going to save you time and money. Who you work for and how you get mentored in your first couple of positions makes a huge difference. In the ER, you have direct access to the doc you are working with. You get critiqued on your thought process immediately so you learn how they think and see gaps in yours. Post graduate mentoring is critical to your development as a practitioner. Going to PA school is probably going to require you to take 2-3 full time semesters of courses to get the minimum to qualify for admission. You won’t need that for NP school. Taking some of them would make you a better NP like cadaver lab anatomy and microbiology. Liability is about the same for both professions. Nurses have typically made a little less even in NP dominant states but that depends some on your negotiating skills. The salary gap is slowly closing.

  13. Bruce says:

    Pre-med likely won’t get you into PA school. The prerequisites for PA school are more rigorous because they expect you to come with a certain knowledge base. You only have 27-36 months to build on that. If you are switching from Pre-Med to PA, be prepared with some really good reasons and get some good recommendations. As far as time goes, you can count on 50 hours as a typical full time professional work week. If you are in an academic center and work for one of the docs with a clinic, research and other duties, you can expect 60-70 hours. People do that to get the reference and the institution name on their resume. If you want to work part-time, no real benefits, just practice clinical medicine 5 days a week, if you work 30 hours of seeing patients, expect 1-2 hours per day admin time. You can usually get a higher salary per hour because you are not drawing benefits. You can negotiate other untaxed benefits also. It all depends on your specialty. I know family practice docs who split a job, each working 20 hours of patient care and 3-5 hours of admin. The admin hours are usually unpaid because you are salaried. If you want to be in a surgical specialty, you are going to put in lots of hours at either level. When medicine was more male dominated, the career was compared to having a mistress. Lots of time, money and emotional energy are required to keep things happy.

  14. ANNA says:

    Thank you for taking the time to reply to my comment. I am still in my basic classes in community college. I desire more than anything to be in the medical field. I’m thinking from RN to PA to a doctor. What suggestions do you have, to help me get more knowledge on the career. I.E, books? Non credit classes? Websites? Programs?
    Any thing helps!

  15. Syed says:

    I am looking to switch from the business field to a PA career Path in the state of Illinois , particularly in Chicago. When you say they require you to have a certain knowledge base, what would that be? One of the schools I saw listed prerequisite science courses and the GRE as prereqs

  16. Bruce says:

    Three great schools in Chicago, Rosalind Franklin, Rush and North Western. Every school requires a BS, a certain number of Prerequisites in science and math and usup ally the GRE and experience. Go to some open houses, set up a meeting with a member of the admissions committee, find out what they want. When you visit don’t make this about you, make it about getting information and creating a relationship with the person you talk to that is unforgettable in a very good way! You want them to have a good positive feel for you so ask questions and do not talk much.

  17. Erika says:

    Hi Bruce. I love your website. It has helped cement my decision to go the PA vs. MD route and provides a steady stream of helpful information as I continue down the pre-PA road. I read your comments in an earlier post that schools want to see an ability to succeed while taking at least 15 hours of science coursework during a semester. I have not been able to do this — not due to laziness, but due to lack of finances. I graduated from Duke for my undergrad degrees (art & psych), but I was left with zero science credits that would count toward PA school. It was after years of banking that I realized my professional life felt lackluster and meaningless. I had a series of personal experiences that led me to look toward service in healthcare as being something that would be intellectually stimulating and also make me feel like I’m doing something helpful in my work. I began in January 2011 at Methodist (a local university that also has a PA program) taking Chemistry 1 & 2 at night (4 weeks each) in the Spring; Organic 1, 2, and Biochemistry that summer; Biology and A&P 1 in the Fall; and A&P 2 and Micro this Spring semester. I worked full-time while taking Chemistry and had to stop in the summer, because that was the start of “daytime” classes, and my job schedule would not permit such an absence. There is a limited amount of financial aid available through the government to students who already have an undergraduate degree but are not in a full-time masters/doctoral program. There ARE private loans that can be taken out, but my husband and I did not feel it was a very financially savvy thing to do. My undergrad GPA was 3.7, and so far my science GPA is 4.0. My GRE is 1180 (a 50/50 split for V & Q), and 5.5 analytical. I will take the CNA test near the end of this semester and begin work full-time as a CNA hopefully around June of this year. Do you think the way I have chosen to go about completing my prerequisites and patient contact hours will greatly harm my chances of being admitted to a PA program?

  18. Lyrehs says:

    Bruce, I am a 42 year old teacher, with a partial nursing background whom has always had a love for the medical field and due to misguidance by a college advisor I didnt pursue my dreams. I stopped taking the premed courses and concentrated on a BS degree in psychology. Due to the medical field bug still nipping at me, I attempted a CD2- second degree in the nursing field. Wasnt what I wanted, so I went to my first love teaching. I have been teaching for several years now,but that medical field itch is still there. So, I am contemplating PA, I know they say your never too old, but how long will it take? Will any of my premed or nursing courses count? Are you able to continue to work while becoming a PA? Any advice you can offer will be great! Thank you!

  19. Tori says:

    Hi Bruce! I’m currently a first year student at an optometry school and I’m starting to realize the scope of practice is very limited in optometry and have recently discovered the option of becoming a PA. I’ve been doing lots of research checking out PA schools but it seems that they all have somewhat different requirements and are very competitive. I’m not sure where to start or if it is better to shadow different MD’s or PA’s or both? I’m going to finish out this first year so I can get credit for it. I’m really attracted to a career as a PA because of the flexibility in the field and being able to choose a specialty if I find an area I really love. Can you offer any advice? I was planning to start applying soon for Aug 2013 however the fact that some schools require 1000 hrs of shadowing/working I may have to look into taking 2 years off and applying for Aug 2014. Also, do you think being previously accepted into optometry school will help my application or should I not mention it? Thank you in advance for your time!

  20. Bruce says:

    Congrats on your acceptance into optometry school
    You may want to think carefully as Optometry is a great career.
    PA is also but it means being sure you have the right prerequisites and
    then getting experience and you want that to be with PA’s as much as possible.
    Often the courses that get you into traditional medical programs, won’t qualify you for
    PA school because it is so much shorter and you have to have a much stronger base
    when you go. You may want to look at my course here. It is delivered over 4 weeks
    but takes about 20 weeks to go through or you may want to just hire me as a coach
    so I can save you some time. Both can be done on this site. Good Luck.

  21. Bruce says:

    Lyrehs, You are not too old but courses need to be less than 5-7 years and need to meet PA Program prerequisites. You need some work/shadowing time – the more the better up to 1000hours. PA shadowing is better than MD shadowing. You need 3 recommendations for CASPA (most schools use it). Your GPA needs to be 3.0 or better and prerequisite science course GPA a 3.5. Then you need outstanding essays and good luck with the interview. Make a time line. Look at 5 nearby schools, and their prerequisites. Decide what you still need to take and put it and everything else on a time line. See when you can apply. You send in an app in May-Nov (hint – earlier is much better) for starting a program the June/July of the next year. You generally can not work during the program, much too intense. You may want to put that time line together, visit some schools, talk to their directors and also read all the advice I have written on my Squidoo.com lens about the PA Path. There is tons of info on Squidoo and maybe you need a 30minute coaching session. Look on here, top navigation bar, to schedule that. Good Luck

  22. Lyrehs says:

    Thanks Bruce! The more I learn, the more I truly want to do this. Thanks and I will check out your Squidoo.

  23. Bruce says:

    No you will be fine! The hours as a CNA will help. I have a clinic opening in Durham in May, Urgent care, you should apply as we can upgrade your skills and you work with PA’s.
    Send me an email via the contact page and I will reply and send you an email address for you to send me your resume.

  24. Eric Scott says:

    I see that the last entry was a year ago. Are you still offering the mentor program and do you still respond to these queries? I’ll take my chances… My situation is as follows: I am 42, have worked in a community health clinic for two years as a bi-lingual health educator. I have an MA in intercultural service, leadership and management from the School for International Training and my career, prior to focusing on becoming a PA and becoming a health educator I worked as a teacher for low income young adults and as the executive director of a non-profit start-up international leadership development program for low-income high school students. I took no science the first time through college (Vassar) and have completed all my pre-requisites for Pacific University’s PA program at the community college while working full time. I have a 4.0 GPA and plan to apply to start PA school in 2014. Your mentorship program looks like a worthwhile investment. So, 1) is it still available and 2)What suggestions, concerns or comments on my chances to get into PA school might you have based on my brief synopsis?

  25. Bruce says:

    You don’t need the mentor program as you have patient hours and a plan with good grades to back it up. What you need is a strategy for writing your essays and interviewing. Hopefully you have some PA’s to recommend you. You can not replace the base of courses with excellent grades. But that only gets you over hump #1. Hump #2 is to get noticed. Your references and essays do that. Along with your life experience. All this is to create the impression in the mind of the committee member that this is someone I have to meet. The interview convinces them you are the one. Unfortunately in our country, we hire or accept less qualified people if they interview better than those with better qualifications. It is the “Extrovert bias” and shows up everywhere. So you have to have an interview and writing strategy that will resonate with the reader/interviewer. You don’t need my program, you need to talk with me. I do run my coaching program and the course runs itself. We might be able to get everything done in one 30 minute coaching session, I usually take a full hour, but you might need a second. That will be your call. The sessions are $35 per 30 minutes. I usually do them during my one hour commute home.

  26. Casey says:

    Hi Bruce,

    SOS! I am a junior in undergraduate school. I am studying health sciences with a minor in biology. I decided that I wanted to try the PA route my sophomore year. I worked extremely hard this past year, but my grades just did not reflect that. My science GPA is a 3.0 (with chem 1/2, bio – organisms, and cellular and molecular biology), while my cumulative is a 3.6. Ahead of me I still have organic, biochem, genetics, anatomy, physiology, and microbiology. I am slowly realizing that maybe I am not competitive enough for this career and workload. I loved and enjoyed my biology classes so much, but it is so difficult to get those exceptional grades. I know that I want to work in the health care field and I thought PA would be the most exciting, perfect fit for me. After my heartbreaking realization, I began to look into OT. I am just afraid that the work will become redundant and possibly not as intellectually challenging and lucrative. Do you think I should go OT and give up PA? I just don’t think I will be able to get the grades and be a competitive applicant. Thanks so much in advance!

  27. Bruce says:

    How bad do you want it? Will you give up social time, hire a tutor, work extra hours in the library with people in your class who are getting it unitl you do.
    I can not tell you what to do, but I can say there is a price and if it is not worth paying, don’t do it! If you want it, find the way to the goal. It can be done
    but if you are like me, it takes more that it does for others. Decide you are, then find a way. I took much inspiration from Sir Ernest Shakleton who became a hero of mine
    from the 5th grade when I read “Shakleton’s Valliant Voyage”. There is a lot more about him know today. He saved the lives of all his men in very perilous conditions.
    If he can do that, you can make good grades. Find a way.

  28. Taryn says:

    I attended the premed program at A&M and am in the process of applying to PA schools. I realized that the essay is an essential component. Any suggestions?

  29. Jean says:

    Hello Bruce ,

    I am going to be a senior in undergraduate school next fall and my major is Biology. I want to thank you for all your insight on this topic.I know I want to work in the medical field , my problem is deciding what I want to do , as there are endless options.

    My question is , if you were to do it again , would you become a physician ? The reason I ask is that some of the cons you listed would become pros if you would have become a physician.

    Thank you again so much for your time and knowledge,


  30. Bruce says:

    Jean, Yes I would do it again because the career turned out very well. Medicine is a very stressful occupation and you have to take care of yourself. The quality of your life depends on where you practice, who you work with and in which specialty. If you want autonomy then primary care is it. If you want a life then private practice with a 9-5 specialist is the way to go. There are so many opportunities now and most states are good places to work. It has taken years for this to happen. PA’s in many states can own medical practices which is a huge change in the last 3-4 years. This occupation is a great one but we are always going to be dependent practitioners. If you don’t mind that, then this is a great occupation with 1/4 the cost and time to get in and get started.

  31. Bruce says:

    Taryn, Make it more of a story, don’t repeat any info from the application, use active verbs and good nouns, be active not passive and no adjectives or adverbs – better to use bullet points but they need to be points not covered in the application.
    The person reading your essay will likely read 15-20 the night before the meeting to discuss who to invite for an interview. They will be tired. What can you say that will make them read the next sentence until 600 words later, they say, “I have to meet this person.”

  32. Anna says:

    Bruce, I just have a few simple basic questions.
    Can I complete nursing school, be a nurse for a few years, save up money, and then enroll in medical school to become a P.A?
    (I’m in a community college at the moment. )
    Or do I have to know for sure now, that I want to become a P.A? What kind of degree do I need to pursue in a community college to transfer to a university and eventually into medical school?
    Just curiously kicking in. I am devotedly interested in the medical field, but don’t know where to begin.

    Thank you,

  33. Bruce says:

    Pick what you want to do and pursue that. Going to nursing school only planning to quit and do something else takes up a spot for someone who really wants to be a nurse. Become an EMT and volunteer. Get some road, transport and ER experience. Ask to round with or observe PA’s and Docs in what they do – called shadowing. Make some great grades in college and get in some of the prerequisites in science to see if you can do the work – both PA and MD require organic chemistry with a lab. Take basic chemistry for science majors and then organic, get A’s or high B’s, you are a good candidate. If you want to be a nurse, do it, take the 2 year track and if you like it most hospitals will pay for your BSN and then you can go many Masters level specialties. NP is like PA but from the nursing point of view. Most of the CVS MinuteClinics are staffed by NP’s. Good luck, take it one step at a time.

  34. Anna says:

    Thanks for your prompt and helpful response! I have looked into this profession elaborately. I read somewhere online that PA’s must complete 100 hours of continuing medical education every two years ( what exactly does this mean? Going back to school every two years?)
    Last question; if in the case, a PA Doesnt pass the recertification exam that’s required every six years, what happens then? Do they get suspended? How do the exams work? Is it something that they evaluate your knowledge? Or do the tests change dramatically?


  35. Bruce says:

    you should look at the NCCPA ( national commission on certification of physician assistants) a .org site. They are the national governing body and of course each state has its own laws. continuing medical education is covered there, there are 2 types, and what you have to do to remain certified. If I am not certified, I loose my license. No license, no opportunity to practice. The tests have changed significantly over the years I have been a PA. They have to, knowledge changes and you have to stay current. 50-75% of what I learned in school is obsolete now. No problem, my knowledge is current in my field.

  36. Noor says:

    Hey Bruce! i really appreciate all that you are doing to help everyone out in this field. I’m a highschool graduate and am really looking into becoming a Physician Assistant but I don’t know about how to becoming one. Can you please show some light into the matter so I can get a clearer view of what I need to do next. My dad really wants me to go into Nursing, he pointed out saying that after every two years you had a certificate in your hand and could start working just with your associates and get upto 50-60,000 and then do 2 more years get your bachelors and then masters. does that go for Physician Assistant as well? or will I have to complete all my 6 years and then get a job to start getting paid? Please help I don’t have much time to decide since colleges here in Illinois will be starting soon :/

  37. Bruce says:

    You have to have a license to practice, you have to pass a national exam to get a license and you have to finish the program to qualify to take the exam. 6 years first. I would look at salary.com and compare 2 year RN salaries in your area. I also would call the local hospital and health department and see if they hire them and call the program and ask the average starting pay of their graduates and where they work upon graduation. Nursing is a completely different profession. I you want to be making decisions for patients and participating as a decision maker, PA or MD is your route. If you want to be on the front lines with patients, but not the decision maker then what your dad suggests is OK. It depends on what YOU WANT to do. You will be doing it a long time. If you want to go to PA school you will have to take the hard sciences nurses don’t take to qualify to get into school. Nursing is a good but completely different career path.

  38. Levi T. McMahan says:

    Hello Bruce,

    I am a Psychology Major, and will be obtaining my Bachelor’s Degree in said major. However, I will be taking all pre-requisite coursework for South College’s P.A. Program, and Lincoln Memorial University’s P.A. Program, both located in East TN. I have maintained a 3.2 GPA, but my only real concern in regards to being accepted to a P.A. program is obtaining relevant healthcare experience. I plan to volunteer at several local hospitals including University of TN Medical Center, Children’s Hospital, and Fort Sanders Regional Medical Center. I work full-time, and must do so because I support myself and my wife, who is currently in school to become an RN, so my options for obtaining healthcare experience are limited. Do you recommend any additional options for obtaining healthcare experience that might be flexible in scheduling? I know that working while in a P.A. program is highly discouraged, for obvious reasons, so my wife will be working while I am in the program, but I would like to already have all my “ducks in a row” by the time I am able to apply, and hopefully get accepted on the first attempt.

    Your attention and response is greatly appreciated.

  39. Bruce says:

    What do the programs require? Will they accept your hours? I usually tell people to become an EMT and volunteer where PA’s are employeed, like the ER but EMT’s end up in the ER frequently anyway. Bottom line, the program has to say what you did meets their criteria. When in doubt, ask them.

  40. Levi says:

    Thank you for the response sir, the programs here do not require anything specific in regards to healthcare experience. However, the more experience I have the more competitive I will be. For instance, if the decision was between myself or one other person for acceptance, and my only experience was volunteer work, but the other person was a paramedic, they would have a better chance at getting into the program, assuming we had very close academic histories.

  41. Megan says:


    I am a junior in undergraduate school and I am currently majoring in biology with a concentration in secondary education in science. My sophomore year I was planning to go to PA school and when I decided I don’t care about how much money I will make and that I just care that I’m doing something I like. So, I decided to switch to teaching. I’m now having second thoughts that I might be happier being a PA or doing something in the med field. I’m mainly having these second thoughts because I have a 3.9 and I often get people criticizing me for wasting away my intelligence on teaching and that I have the potential to do something that makes more money. I really love the lifestyle of teaching and it’s crucial to me to have a family life but at the same time I don’t want to feel guilty my whole life for selling myself short. Do you think this is a reason to switch back to a focus on PA school, or should I stay with teaching because I like the lifestyle? I also feel that I would enjoy certain things about both professions while disliking things about both as well so that also makes it harder for me to decide. Thanks for having this site some of the comments above have already helped!

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