Observing a physician assistant (PA) and a nurse practitioner (NP) in practice, you might not see the difference. They share many of the same duties and responsibilities: writing prescriptions, developing treatment plans, ordering tests. Both are trained clinical health providers with advanced degrees and clinical preparation, and they must be nationally certified in order to practice. 

But the two professions have key differences. A physician assistant receives a generalist education modeled after medical school. Upon graduation, they are prepared to treat the whole patient and develop areas of specialty through clinical practice. An NP, on the other hand, typically specializes in a patient population while in school, such as geriatric, acute care, psychiatric mental health, or women’s health.

Learn more about the careers of PAs vs. NPs and find out which is the better fit for you.

A nurse practitioner is a registered nurse (RN) with the advanced clinical expertise needed to prevent, diagnose, and treat health conditions, as defined by the American Association of Nurse Practitioners (AANP). They develop comprehensive treatment plans in collaboration with patients and integrate insights from the entire medical team, including physical therapists, speech language pathologists, registered dieticians and others as needed. Nurse practitioners (NPs) typically specialize in a particular patient population, such as families, neonatal infants or older adults.

In daily practice, nurse practitioners use a holistic approach. For primary care, this includes addressing social determinants of health, preventing disease and promoting health management. NPs support their patients in practicing healthy lifestyles — scheduling regular health screenings, getting physical activity, stopping unhealthy behaviors such as smoking — that can help prevent chronic diseases. This emphasis on preventative care can ultimately lead to lower health care costs, making NPs essential to creating a more efficient and effective health system.

Common responsibilities of a primary, acute or specialty care NP include:

A physician assistant is also a medical professional who works with the entire clinical team to manage a patient’s care, as described by the American Academy of Physician Assistants (AAPA). Training for PAs is modeled on medical school education. While NPs specialize in a patient population, PAs receive a generalist preparation with rotations in a variety of specialties and subspecialties. Through rotations, and later through practice and continuing education, PAs develop expertise in particular populations, conditions and bodily systems.

Physician assistants make diagnoses, create treatment plans and prescribe medications. Common responsibilities of a PA include:

Physician assistants and nurse practitioners undergo rigorous training to prepare for medical practice. This training typically includes academic and hands-on work. Read further to explore options for PA vs. NP education.

PAs receive a master’s degree-level education. To become a PA, a PA school student must:    

After becoming licensed, physician assistants must maintain their licensure through continuing medical education and recertification exams every 10 years.

Registered nurses aspiring to become NPs may complete either a master’s or doctoral degree program. This could be a Master of Science in Nursing (MSN) or a Doctor of Nursing Practice (DNP) degree.

To become an NP, a nurse must:

Similar to PAs, nurse practitioners must maintain their clinical competencies through continuing education.

The demand for health care services will increase as the U.S. population grows and ages, according to the Bureau of Labor Statistics (BLS). Physician assistants and nurse practitioners are positioned to provide essential care to patients. Learn more about the PA vs. NP salary below.

*as of May 2018

BLS data indicates that employment of PAs is projected to increase 31% between 2018 and 2028.

Physician assistants may practice in a variety of settings. The most popular settings as per a 2019 AAPA Salary Survey of clinically practicing PAs in the United States include:

PAs also work in all medical specialties. The same survey shows that the most common specialties include:

Most physician assistants work full time and often earn a salary higher than $100,000 each year. The 2018 median pay of PAs was $108,610 per year, but it can vary based on the setting. As of May 2018, the BLS reports the following physician assistant salaries in various work environments:

Similar to PAs, nurse practitioners work in a variety of settings. The BLS shows the following breakdown of work environments for nurse practitioners, nurse anesthetists and nurse-midwives:

The BLS predicts NP employment will increase 26% between 2018 and 2026. The 2018 median salary for NPs was $107,030. However, salary varies by clinical specialty and work setting. As of May 2018, the BLS reports the following salaries for NPs, nurse anesthetists and nurse midwives in various work environments:

Find out what salaries nurse practitioners earn in your state.

After completing their degree programs and clinical hours, physician assistants and nurse practitioners must obtain specific certifications and licensure to provide care to patients. 

The AAPA outlines the steps to becoming a practicing PA:

Those who pass the PANCE exam receive the title of physician assistant-certified (PA-C).

The steps to becoming a nurse practitioner are similar, as indicated by the AANP:

Nurses who complete the degree program and receive certification become an advanced practice registered nurse (APRN). This includes certified nurse-midwives (CNM) and family nurse practitioners (FNPs).