Many students interested in medicine and healthcare must choose between becoming a doctor by earning an MD or DO and becoming a physician assistant or nurse practitioner. Even though they all significantly overlap, they also significantly differ from one another. If you’re the kind of person who would enjoy being a doctor, you might not enjoy being a PA or NP as much, and vice versa. Keep in mind that all three are excellent careers; none are superior to the others. Simply decide what is most important to you and make a decision based on that.
The MD or DO training path for doctors is by far the longest. You will complete four years of premedical study in college, followed by four years of medical school and three to seven years of residency in your chosen specialty. Add one or more years after that if you want to pursue a fellowship to further your subspecialization.
After college, you’ll enroll in physician assistant school, which lasts for two or two and a half years and prepares you to work as a physician assistant. In contrast to medical school, where you spend two years primarily focused on didactics and two years primarily focused on clinic time, PA school only requires one year of didactics and the remaining 12 to 18 months are spent primarily focused on clinical exposure. Following that, there is no residency and you can begin working as a PA right away.
There are two routes you can take to become a nurse practitioner: traditional or direct entry. The conventional route involves passing the NCLEX exam, then earning your BSN, ABN, or MSN to become an RN. To become an NP, they then enroll in a master’s or doctoral program. It typically takes two years to complete a full-time master’s program, but it could take up to five years to complete a part-time DNP program. You could become an RN soon after graduating from college and a fully trained NP in just two years if you chose to major in nursing and pass the NCLEX.
Along with training time, each path’s level of competition and rigor must also be considered. Of the three, getting into medical school is by far the most difficult. Over 80% of premeds on the first day of college at some universities, like UCLA when I was there, are no longer premeds by the time they graduate. And only 40% of those who eventually apply to medical school are accepted. The typical matriculant statistics are an 83 on the MCAT and a 3. 73 GPA.
In terms of competition, PA school comes next after medical school. The average GPA for accepted PA students is 3. 5 with an average GRE score between the 40th and 50th percentile. Keep in mind that they do have a lower average acceptance rate (33% of all applicants), which can lead students to believe that PA school is more competitive. Any confusion is typically clarified when you consider the results if the average premed student with higher stats applied to PA school or the average pre-PA student with lower stats applied to medical school.
Be aware that many PA programs also demand that applicants have over 1,000 hours of experience providing direct patient care prior to matriculating. It doesn’t get any less competitive because of this, but you’ll need to put in a lot of time to get those hours. Premeds don’t need 1,000 hours of hands-on patient care, but they do need to invest several hundreds of hours in a variety of extracurricular activities, such as clinical experience, research, volunteering, leadership, and others.
The least competitive of the three is NP school, which also has the laxest requirements. While some programs call for one to two years of prior nursing experience, others don’t. GPA isn’t emphasized as a major consideration, with most GPA cutoffs being around 3. 0, but this isn’t a hard rule. According to reports, Middle Tennessee State University, for instance, typically accepts applicants with a GPA of 2. 9 or greater.
Your clinical years in medical school and your residency years will be very demanding in terms of rigor. The typical work week is between 70 and 80 hours, but most surgical specialties require more than 80 hours. You won’t need to put in as many hours or spend as long on the PA and NP training paths.
The most expensive schools in terms of cost are medical school, PA school, and NP school. The average annual cost of attending medical school is between $40,000 and $60,000, and graduates typically graduate with debts of around $200,000. The average annual cost of attending PA school is $45,000, and the average debt at graduation is about $110,000. NP tuition ranges from $18,000 to $32,000 annually, with an average debt load of between $40,000 and $60,000 when graduates.
It makes sense to assume that doctors have the most in-depth understanding of the human body and how to treat its various ailments, given their training backgrounds. If you assume that, then you would be correct. Physicians spend the most time concentrating on the foundations, but they also spend a significant amount of time in residency concentrating on their particular specialty.
While nurse practitioners adhere to the nursing model, physician assistants adhere to the medical model, much like physicians. However, keep in mind that you are fully prepared and qualified to enter the workforce after graduating from PA or NP school and that no residency is necessary for specialty training. After joining a practice, PAs and NPs receive the majority of their specialty training on the job. Even though this is a great way to pick up pattern recognition quickly for common presenting issues, you won’t be well prepared to recognize and treat uncommon or complex conditions.
It’s also much simpler to switch specialties later in your career if you get bored with one or want a change of pace thanks to the on-the-job training. Physicians would have to reapply for residency and complete an additional 3 to 7 years of structured training, so doing that is not practical. PAs are thought to be the most adaptable and can occasionally be found in surgical specialties, where they help in the operating room or handle pre- or post-operative patient floor work. NPs also have flexibility, but you must choose your program carefully because each one trains you for a particular specialization, such as primary care, acute care, family, women’s health, and so forth.
You should be aware that only surgeons with an MD or DO are qualified and have the necessary knowledge and experience to perform surgery if you are interested in having surgery. The most you can do in the operating room with the PA or NP routes is first assist, assisting the surgeon by retracting, suctioning, suturing, and performing similar procedures. A medical student or junior resident would be held to that standard of responsibility. This brings up the contentious issue of scope of practice.
In the past, the NP and PA training programs were developed to fill a gap in primary care physician availability and to supplement physician-led care rather than to replace it. In this model, NPs, PAs, and doctors collaborate effectively on behalf of the patient. Midlevels typically worked alongside physicians because they have the most extensive knowledge and training, so they could easily ask for help with more complicated or uncommon presentations.
On the one hand, NPs and PAs are pushing for a wider range of responsibilities, which means they want to take on more tasks that physicians typically perform, like independent practice. The main arguments are twofold: first, midlevels can help address the shortage of primary care physicians that we currently face. Additionally, they contend that midlevel practitioners receive adequate training to work safely and independently.
However, medical professionals are fighting back, primarily out of concerns for patient safety. After all, NP’s and PA’s receive far less training. My medical mentors and peers have mentioned that they value the NPs and PAs in their practice for handling many of the routine and straightforward cases. However, the training disparities are glaringly contrasted when it comes to a complex or uncommon presentation.
Comparing the knowledge and skills of someone who has over 20,000 hours of supervised patient contact compared to just 500 to 2,000 hours of contact seems like a no-brainer, but are doctors really more qualified? It would seem obvious that a doctor with 20,000 hours of experience would have more clinical knowledge than an NP or PA with only a small portion of that. The only way for everyone to be equally qualified, despite the vast disparity in training hours and intensity, is if the following assumptions are true: either medical school is vastly less efficient and medical students are vastly less intelligent or capable, or if midlevel training paths are vastly more efficient and their students are vastly more intelligent or capable.
Scope of practice creep is very much about money. After all, you can earn a salary that is closer to that of a physician if you have more capabilities and can work more independently. The typical primary care physician earns $240,000 annually, while the typical specialist earns $340,000. NPs earn an average of about $110,000 annually, while PAs earn an average of about $100,000.
Patient safety is why this is significant and you should be concerned. This is extremely relevant to you if you or anyone you care about will ever need medical care. Anesthesiology and primary care are the fields most severely impacted by scope creep at the moment. But if you visit Reddit or medical Twitter, you’ll notice that other specialties are emerging. In the end, surgical specialties are the least vulnerable to scope creep problems.
Two main factors explain why scope creep has advanced so far if it is ultimately harmful to patients: first, in the current environment where emotions trump facts, many organizations are excessively focused on inclusion. Although we are all equal as humans, that doesn’t mean that we are all equally skilled or capable. Second, and more importantly, compared to the AMA and physicians, the AANP and AAPA are much more successful at lobbying. It’s simple to blame doctors’ crazily busy schedules for why they don’t have time for advocacy work, but that needs to change. Visit Physicians for Patient Protection if you want to learn more, get involved, and make a difference.
Doctor vs PA vs NP | Which is Right for You?
PA school requirements
The requirements for different physician assistant programs can vary. However, you can use the following typical requirements as guidance:
Bachelors degree
Candidates for all physician assistant programs must hold a bachelor’s degree from a university that is accredited. Although people typically pursue a degree in a field related to science or healthcare, these programs do not specify requirements regarding your major. You could gain an advantage by selecting a major that complements the prerequisite courses needed by physician assistant programs. Anatomy, biology, chemistry, kinesiology, or sociology are a few examples of common undergraduate degrees for physician assistants.
Prerequisite coursework
The prerequisite courses that physician assistant programs require applicants to have taken as undergraduates may vary. These programs typically demand a mix of science and non-science coursework. You can use this coursework to get ready for the more complex ideas you’ll learn in the PA program. Common prerequisite courses for PA programs include:
Consider taking more difficult science-related courses to demonstrate your knowledge at a deeper level. For instance, you could study physics, genetics, organic chemistry, and biochemistry. Once more, you can research PA programs to learn about their minimal prerequisites. Studying beyond those requirements can help you stand out from other applicants. For instance, some programs value candidates who have studied a foreign language.
GPA
Physician assistant programs may set minimum GPA requirements for applicants. These programs typically seek applicants with at least a 3. 0 GPA, though some set a lower or higher minimum. A high GPA often refers to a score between 3. 5 and 4. 0. Along with the applicants’ overall GPA, the GPA from their science coursework and non-science coursework may be looked at. You can calculate your GPA throughout your academic career to ensure you meet the requirements by researching programs’ GPA specifications and the typical GPA of accepted applicants.
Relevant experience
Typically, applicants to physician assistant programs must have prior medical experience. Depending on the program, they might establish a minimum number of hours in patient care or healthcare that must be completed. By applying for internships or entry-level positions at medical facilities like doctor’s offices, hospitals, or long-term care facilities, you can gain experience working in the healthcare industry. You may find employment as an emergency medical technician (EMT), medical assistant, or certified nursing assistant depending on your interests or educational background.
The fact that you have prior healthcare experience demonstrates both your interest in medicine and your readiness for the physician assistant program. You can use additional relevant experiences that may help you as a physician assistant in addition to your professional clinical experience. You might, for instance, highlight any leadership positions you’ve held, scientific or medical research you’ve done, or volunteer or extracurricular activities you’ve engaged in.
GRE
Typically, applicants to physician assistant programs must take the Graduate Record Examinations (GRE). This uniform, multiple-choice exam demonstrates candidates’ readiness for their graduate degree program. Some PA programs have minimum score requirements, usually 295 or higher, though there may be exceptions. Up to five times per year, you can take the GRE, and you can decide which results to send to schools. To get a better idea of your target score and the GRE requirements for various programs, do some research on their average GRE scores.
CASPA
People can apply to several physician assistant programs at once using the Centralized Application Service for Physician Assistants (CASPA). As you draft your applications, keep in mind that not all physician assistant programs use this service and consult the application guidelines. A personal statement and letters of recommendation are two crucial elements of the CASPA application. Your preferred physician assistant program may have similar application requirements even if CASPA isn’t used there.
The personal statement question asks you to explain why you want to become a physician assistant. Make the most of this opportunity to stand out from the competition by emphasizing your skills, qualities, and experiences. Additionally, the CASPA requests that you submit the names of three to five people who can assess your qualifications. Choose people who have witnessed you working in a professional capacity and interacting with patients if at all possible. Before proceeding, obtain their consent. CASPA will send them an evaluation request form to complete and submit.
Should I go to med school or PA school?
Physicians and physicians assistants both perform essential patient care responsibilities. Their respective responsibilities may overlap because both individuals diagnose and treat medical conditions. However, physician assistants typically work under licensed physicians supervision. For instance, doctors can perform surgeries with the help of physician assistants. The range of duties for physician assistants varies by state because some have limitations on the amount of authority they can exercise or the level of supervision they need.
Those who want to become doctors must enroll in medical school, while those who want to become physician assistants must complete physician assistant programs. Before they can work as professionals, doctors must select and complete their medical specialization training. By learning more about the education requirements for these roles, you can decide which career path is best for you.
How long is PA school?
The average length of a physician assistant program is two to three years. The first year typically focuses on classroom and laboratory instruction. Students can apply their medical knowledge and gain clinical experience in the program’s second half. Under the guidance of practicing doctors, students complete clinical rotations in hospitals or clinics. They could participate in clinical rotations in fields like internal medicine, family medicine, or emergency medicine. Learning about various medical specialties can assist students in deciding which field to pursue.
Medical school requirements
Similar to physician assistant programs, different medical schools may have different admissions standards. You can use the following requirements as guidance:
Bachelors degree
Medical schools require a bachelor’s degree from an accredited institution, just like physician assistant programs. People can apply to medical schools either after they graduate or while they are still in their degree programs. Although there are no specific requirements for majors at medical schools, you might want to think about a pre-med track or a major in health care. Most people who apply to medical schools major in a science, like biology, chemistry, or physics.
Prerequisite coursework
Medical schools require varying prerequisite courses. To make sure you enroll in appropriate courses as an undergraduate, you can research the requirements set forth by your desired medical school program. Your coursework will demonstrate your practical expertise and get you ready for the more challenging coursework you’ll encounter in medical school. Common prerequisite courses for medical school include:
GPA
Medical schools frequently demand that applicants have strong undergraduate academic records. These schools may have GPA specifications, and frequently look for at least a 3. Although different medical school programs may have a different minimum score, Again, a score between 3 and 5 is considered to be a high GPA. 5 and 4. 0. You can look up the typical GPA reported by the programs you’re interested in to see if you meet their requirements.
Relevant experience
Your chances of being accepted to medical school can be aided by prior relevant experience. Schools consider a variety of experience to gauge your interest in medicine and readiness for the program. For instance, you might look for opportunities to work as an EMT or medical assistant in order to gain clinical experience. You can get the chance to observe practicing doctors in various healthcare settings as an undergraduate. Some programs also seek applicants with relevant research experience.
You can also emphasize experiences related to leadership roles, volunteer work, and extracurricular activities, similar to programs for physician assistants. Explain why these experiences are relevant to a career as a doctor when referencing them. For instance, they might demonstrate your dedication to assisting others or your interest in scientific subjects.
MCAT exam
Candidates for medical schools must take the Medical College Admission Test (MCAT). This uniform multiple-choice exam evaluates your capabilities as a medical school candidate. Your overall MCAT score can be between 472 and 528, but most schools prefer applicants who have at least a 508 score. To learn what score you should strive for, you can research the requirements for the medical school programs you’re interested in or information on the test scores of students who were accepted.
Within one testing year, you are permitted to take the MCAT up to three times. Your prerequisite courses will help you get ready for the test, which will cover topics in the natural, behavioral, and social sciences as well as critical thinking and problem-solving abilities. You can look for MCAT prep classes or a tutor to help you study for this exam.
Letters of recommendation
Medical schools frequently require at least two letters of recommendation for applicants, though requirements can vary. Academic advisors, professors, or working medical professionals may serve as your referees. These people will be able to attest to your excellent academic and professional credentials. Study the requirements for the programs you are interested in, as some have unique demands regarding the quantity and kind of letters needed.
How long is medical school?
Medical school typically takes four years to complete. For the first two years, instruction takes place in classrooms and laboratories. Students gain clinical experience by completing rotations at hospitals or clinics during the second half of medical school. Students apply their medical knowledge by diagnosing and treating patients under the guidance of practicing doctors. Graduates of medical schools frequently enroll in residency programs based on the specialization they want to pursue after graduation. Programs for residents can last three to nine years and are frequently held in hospitals or clinics.
PA school coursework
You can research your desired programs to find out about their specific curriculums because the coursework offered during physician assistant programs varies. Anatomy and physiology-related classes are frequently offered to PA program students during their coursework in the classroom and laboratories. These curriculums also have coursework on healthcare-related topics, including:
Med school coursework
Similar to physician assistant programs, medical school’s curriculum varies. You could investigate various medical schools to learn about their specific curricula and see if they suit your interests. Depending on the type of medical degree you want to pursue, the curriculum may also change. Students initially participate in coursework on scientific topics like anatomy, physiology, histology, and biochemistry. Students study various medical specialties in their final years, including family medicine, internal medicine, and surgery The following are additional examples of the coursework available in medical school programs:
FAQ
Should I go to medical or PA school?
The best way to decide between becoming a physician and a PA is to shadow both. Also, consider the role you want in the healthcare team. Don’t choose PA just because the training is shorter if you would be more suited to becoming a doctor.
Is PA school harder than med school?
PA school is much more difficult than med school. Compared to medical school, PA classes are longer and more in-depth and must be completed in half the time. The average class size in medical schools is 2-3 hours, while that in PA schools is 6-8 hours. While PA lectures are typically required attendance, medical school classes are strictly optional.
Is it easier to get into medical school or PA school?
The competition for medical school is generally much higher than for PA school. It takes four years to complete medical school, including two didactic years and two clinical years. In didactic years, classes typically run from 8 to 12 hours per day, with some small groups for learning physical exams scattered throughout.
Is PA school like medical school?
Then, aspirants to become physician assistants enroll in a two- to three-year PA program, while aspirants to become doctors enroll in a four-year medical program. Prior to applying, both routes require specific science prerequisites and relevant experience. Both put a lot of emphasis on clinical rotations in the curriculum’s latter half.
