Nurse practitioners (NPs) and physician assistants (PAs) are advanced healthcare practitioners with similar responsibilities, such as diagnosing illnesses and prescribing medications. However, training and paths toward certification between a PA vs NP differ in significant ways. Let’s unpack the differences between NP vs PA to help you determine which career path best aligns with your goals.
What Is a Nurse Practitioner?
A nurse practitioner (NP) is a licensed clinician who provides comprehensive healthcare to patients of all ages. An NP can work in virtually any healthcare setting, diagnoses patient conditions and prescribes medications.1 As of October 2023, nurse practitioners have full practice authority in 28 states, meaning that they can practice independently without the supervision of a physician.2
The key responsibilities of a nurse practitioner include:1
- Diagnosing and treating acute and chronic conditions.
- Prescribing medications, therapies and other treatments.
- Managing general patient care.
- Performing and interpreting diagnostic tests (e.g., x-rays, lab work).
- Educating patients about healthy lifestyle choices and disease prevention.
- Counseling patients about their health care plan.
- Holding specialty-specific responsibilities.
What Is a Physician Assistant?
A physician assistant (PA) is an advanced practice provider with a Master of Science in Physician Assistant Studies (MSPAS), licensed to provide many of the same clinical services as physicians when working in primary care settings. These services include performing physical exams, diagnosing and treating illnesses and prescribing medications.3
The key responsibilities of a physician assistant include:4
- Taking medical histories.
- Ordering and interpreting lab tests and diagnostic tests.
- Performing physical exams.
- Diagnosing and treating illness.
- Assisting in surgeries.
- Educating patients about their treatment plan.
NP vs PA: Key Differences
What is the difference between a nurse practitioner and a physician’s assistant? The two most fundamental differences between a nurse practitioner vs physician assistant are the training they receive and their work environments.
Nurse practitioners are trained in advanced nursing and focus on a specialized role, such as neonatal nurse practitioner. Physician assistants have a general medicine foundation; their training follows the medical model and covers all foundational aspects of medicine and specialties.
Educational Differences Between Nurse Practitioners and Physician Assistants
Both nurse practitioners and physician assistants are required to earn a graduate degree, complete a clinical training experience and acquire certifications. The difference between PA and NP lies in the type of training and certification requirements.
To become a nurse practitioner, complete the following:5
- Earn a Bachelor of Science in Nursing (BSN) degree: A full-time BSN program typically takes four years to complete.
- Pass the NCLEX-RN: Passing this examination is required to practice as a registered nurse (RN) in your state. Once you pass the exam, you will receive your RN license.
- Earn a graduate degree: You will need either a Master of Science in Nursing (MSN) or a Doctor of Nursing Practice (DNP) — both of which you can earn by studying at USAHS. Each degree program requires a nurse practitioner role specialty, such as Family Nurse Practitioner (FNP). In addition to coursework, NP programs typically include a clinical practicum of at least 500 hours under the supervision of a preceptor.6
- Become a Certified Nurse Practitioner (CNP): Take a national certification exam through one of the five national certification boards to become licensed as a nurse practitioner.7
- Become State Licensed: Apply for licensure as an NP from your state board. For certification renewal, nurse practitioners must take 100 hours of continuing education and 1,000 clinical hours every five years.8
To become a physician assistant, complete the following:9
- Earn your master’s degree: You must graduate from an accredited PA program—typically an MSPAS program. You must also complete at least 2,000 hours of supervised clinical rotation.4
- Pass the Physician Assistant National Certifying Examination (PANCE): Once you pass the PANCE exam, administered by the National Commission on Certification of Physician Assistants (NCCPA), you can receive your state license.
- Maintain national certification: PAs must complete 100 hours of continuing medical education (CME) every two years. They are required to take a recertification exam every 10 years.10
Work Environment Differences Between PA and NP
Nurse practitioners and physician assistants work in primary, acute and specialty care across healthcare settings, including medical offices, hospitals, nursing homes, Veterans Affairs (VA) facilities, correctional institutions and community clinics.1, 4
Although PAs can serve as primary care providers, they are typically required to work under the direct supervision of a physician or surgeon.4 A PA’s scope of practice varies from state to state and is determined through state licensing requirements.
Another difference between a nurse practitioner or physician assistant is that NPs must work under the supervision of a physician in 11 states. However, in 28 states and two U.S. territories, nurse practitioners can operate their practice with autonomy. The remaining 15 states and U.S. territories have regulations that are somewhere in between.2
Specialization Differences Between Nurse Practitioner and Physician Assistant
Another difference between physician assistants and nurse practitioners is the legal distinctions. NPs can work across various nursing role specialties and earn certifications as required.
If an NP desires to switch specialty certifications, such as from neonatal to family nurse practitioner, they need formal education and licensure for that new role. As for PAs, once licensed, they can switch specialties without a new certification or additional job training.11
NP vs PA: Career Outlook
Whether you’re choosing between a career as a nurse practitioner or physician assistant, your prospects are promising. Employment for nurse practitioners and physician assistants is projected to grow over the next decade faster than the average projected growth for all occupations.
The U.S. Bureau of Labor Statistics (BLS) predicts a 38 percent growth for NP roles and 27 percent growth for PA roles between 2022 and 2032.12,13 Also, U.S. News & World Report ranks these professions as the top two roles in 2024: nurse practitioner sits at #1 and physician assistant at #2 in the publication’s Best Health Care Jobs list.14
PA vs NP: Salary
As of 2023, the median salary of a nurse practitioner is $129,480, while the median salary of a physician assistant is $130,020.12,13 Based on BLS estimates, the salary of a physician assistant is slightly higher than a nurse practitioner’s, but not by much.
How to Choose the Right Career Path Between Nurse Practitioner vs Physician Assistant
Comparing the educational requirements, work environments and scope of practice can help you choose between a career as a physician assistant vs nurse practitioner. For example, NPs spend more time counseling patients and their families on health promotion and disease prevention. Physician assistants, on the other hand, may take up a surgical specialty.15
Resources for Nurse Practitioners
The following organizations give nurse practitioners access to professional development opportunities, events and other benefits:
- American Association of Nurse Practitioners (AANP)
- National League for Nursing (NLN)
- American Nurses Association (ANA)
Resources for Physician Assistants
Should you pursue a career as a physician assistant, these organizations will give you a chance to participate in seminars, networking events and professional development opportunities:
- National Commission on Certification of Physician Assistants (NCCPA)
- The Physician Assistant (PA) Foundation
- American Academy of Physician Associates (AAPA)
- The Physician Assistant Education Association (PAEA)
The Final Word on the Difference Between Nurse Practitioner and Physician Assistant
Whether you decide to explore a career as a PA or NP, it’s encouraging to know that the demand for both is increasing within healthcare. Both are rewarding roles that can help patients live healthier and longer lives.
The University of St. Augustine for Health Sciences (USAHS) offers Master of Science in Nursing (MSN), Doctor of Nursing Practice (DNP) and Post-Graduate Nursing Certificates designed for working nurses. Our degrees are offered online, with optional on-campus immersions.* Role specialties include Family Nurse Practitioner (FNP), Psychiatric Mental Health Nurse Practitioner (PMHNP), Nurse Educator** and Nurse Executive. The MSN has several options to accelerate your time to degree completion. Earn your advanced nursing degree while keeping your work and life in balance.
*The FNP role specialty includes one required hands-on clinical intensive and the PMHNP role specialty includes one required virtual clinical intensive as part of the curriculum.
**The Nurse Educator role specialty, available only for the MSN and Post-Graduate Nursing Certificate programs, is not currently enrolling students.
Sources
- American Association of Nurse Practitioners, “What’s a Nurse Practitioner (NP)?”, AANP, 2024, https://www.aanp.org/about/all-about-nps/whats-a-nurse-practitioner.
- American Association of Nurse Practitioners, “State Practice Environment,” AANP, October 2023, https://www.aanp.org/advocacy/state/state-practice-environment.
- Physician Assistant Education Association, “What is a PA?”, PAEA, 2024, https://paeaonline.org/how-we-can-help/advisors/what-is-a-pa.
- American Academy of PAs, “What is a PA?”, AAPA, 2024, https://www.aapa.org/about/what-is-a-pa/.
- Nursing License Map, “How to Become a Nurse Practitioner,” Nursing License Map, October 2021, https://nursinglicensemap.com/advanced-practice-nursing/nurse-practitioner/.
- American Association of Colleges of Nursing, “Clinical Hours”, Frequently Asked Questions, https://www.aacnnursing.org/essentials/tool-kit/faqs.
- American Academy of Nurse Practitioners, “Nurse Practitioner (NP) Certification,” AANP, 2024, https://www.aanp.org/student-resources-old/np-certification.
- American Academy of Nurse Practitioners, “Renewal Requirements,” AANP, 2024, https://www.aanpcert.org/recert/index.
- National Commission on Certification of Physician Assistants, “You’re beginning an exciting and rewarding career; and NCCPA certification is an important step as you begin this journey,” NCCPA, 2024, https://www.nccpa.net/become-certified.
- American Academy of PAs, “CME FAQs,” AAPA, 2024, https://www.aapa.org/cme-central/cme-faqs.
- Ryanne Coulson, “PA vs. NP: A Simple Explanation of the Fundamental Differences,” Be a Physician Assistant, May 2, 2017, https://beaphysicianassistant.com/blog/difference-between-pa-and-np.
- U.S. Bureau of Labor Statistics, “Nurse Anesthetists, Nurse Midwives, and Nurse Practitioners: Summary,” BLS, April 17, 2024, https://www.bls.gov/ooh/healthcare/nurse-anesthetists-nurse-midwives-and-nurse-practitioners.htm.
- U.S. Bureau of Labor Statistics, “Physician Assistants: Summary,” BLS, April 17, 2024, https://www.bls.gov/ooh/healthcare/physician-assistants.htm.
- U.S. News & World Report, “Best Health Care Jobs,” U.S. News & World Report, 2024, https://money.usnews.com/careers/best-jobs/rankings/best-healthcare-jobs.
- Nurse.org, “Nurse Practitioner (NP) vs Physician Assistant (PA): Which Role is Right for You?,” July 27, 2023: https://nurse.org/articles/rise-of-non-physician-roles-in-medicine/.
