Nurse Practitioner vs. Physician Assistant or Associate (PA)

Is it possible to work as a healthcare clinician without becoming a doctor or surgeon? The short answer is: yes! With a master’s degree, registered nurses (RNs) and healthcare workers with bachelor’s degrees in healthcare-related disciplines or business can become nurse practitioners (NPs) or physician associates (PAs), formerly known as physician assistants. 

With a two- to three-year, practice-focused master’s degree and a professional license, NPs and PAs can provide patient care in hospitals or clinics. There are numerous similarities and a few differences between these two clinically-focused healthcare careers.

What are the similarities between NPs and PAs? First, both positions are primary care providers meaning they practice general or specialized healthcare in hospitals or outpatient clinics. Second, NP and PA careers require a minimum of two to three years of schooling in master’s degree programs, which is significantly shorter compared to the eight years of medical school, internships, and residencies required to become a doctor. 

Lastly, depending on the state they practice in, NPs and PAs can fill the gaps in access to healthcare created by an increase in patients and a shortage of physicians. While it’s true that NPs and PAs can’t perform operations, they can offer clinical services and increase people’s access to medical care in urban, rural, and historically underserved populations. 

Depending on a state’s scope of practice laws, NPs and PAs either practice independently or under the supervision of a physician. Compared to doctors, NPs and PAs are limited in the schedule class of medications they are authorized to prescribe.

What is a Nurse Practitioner (NP)?

Nurse practitioners (NPs) are patient-centered practitioners. NPs may have full or limited abilities to see patients and prescribe medication. NPs are one of many advanced practice registered nurses (APRNs) and have more responsibilities than registered nurses (RNs). Most NP graduate (MSN) and doctoral (DNP) programs require two years of coursework and clinical experience. 

There are many specialization areas for NPs, including family, psychiatric-mental health, women’s health, adult-gerontology, pediatrics, nurse anesthetist, and certified nurse-midwifery. Students can earn these specializations at the initial master’s level or through a post-master’s certificate or doctoral program.

What is a Physician Assistant or Associate (PA)?

Physician associates (PAs)are medicine-centered, focusing on treatment over patient care. PAs work with doctors and other independent clinicians to provide patient care in diagnostics management, treatment planning, education, chronic disease prevention, and family planning. Most PA master’s programs require 27 months or three academic years of studying and clinical rotations for certification. As with NPs, PAs can specialize in areas such as general practice, family medicine, neurology, emergency medicine, dermatology, OB/GYN, radiology, and surgery. Typically PAs choose their specialty area before they begin their graduate studies.  

Read on to learn more about nurse practitioner (NP) and physician associate careers, including educational requirements, career outlook, salary, accredited programs, and professional licensure.

Side-by-Side Comparison: Nurse Practitioner (NP) vs. Physician Assistant (PA)

Nurse Practitioner (NP)Physician Assistant/Associate (PA)
Minimum DegreesMaster of Science in Nursing (MSN)
NP Post-Master’s Certificates 
Master of Health Science – Physician Assistant (MHS-PA)
Master of Medical Science (MMS or MMSc)
Optional Doctoral DegreeDoctorate of Nursing Practice (DNP)Doctor of Physician Assistant Studies (DPAS)
Career Outlook (from 2021-2031)46 percent (BLS 2022)28 percent (BLS 2022)
Average Annual Salary$118,040 per year (BLS, May 2021)$119,460 per year (BLS May 2021)
Program AccreditationCommission on Collegiate Nursing Education (CCNE) 
Accreditation Commission for Education in Nursing (ACEN)
Accreditation Review Commission on Education for the Physician Assistant (ARC-PA)
Clinical Hours Requirements (approximate; hours vary by program)500 clinical hours (MSN degree)
1,000 clinical hours (DNP degree)
1,000-4,000 clinical hours
Licensing & Certification OrganizationsState Boards of Nursing (SBONs)
American Academy of Nurse Practitioners (AANP)
American Nurses Credentialing Center (ANCC)
State Boards of Medicine
National Commission on Certification of Physician Assistants (NCCPA)

Career Outlook: NP vs. PA

A nurse practitioner (NP) or a physician associate (PA) career can be extremely rewarding and challenging. NPs and PAs play an important role in the healthcare system, and their services are in high demand. NP and PA positions offer competitive salaries and benefits, and many NP and PA positions offer flexible scheduling options.

The following paragraphs discuss occupational growth for NP and PA careers. 

Nurse Practitioner Career Outlook

The Bureau of Labor Statistics (BLS 2022) projects that the number of employed nurse practitioners will grow by 46 percent from 2021 to 2031. This growth is five times higher than the average for all occupations and is due, in part, to an increased need resulting from current NPs retiring and patient loads increasing. This estimate equates to 112,700 new openings for nurse practitioners in the next decade.

Physician Assistant Career Outlook

According to the BLS, physician assistant employment will grow by 28 percent from 2021 to 2031—more than five times faster than the growth rate for all occupations (5 percent). This rapid increase is partly because many current PAs are nearing retirement age, and there is an increasing demand for patient care. Consequently, an average of 3,840 new PA positions open up each year.

How Much Do NPs and PAs Make?

NP and PA students who complete two to three years of graduate school and clinical hours as nurse practitioners (NPs) or physician assistants (PAs) can expect to earn annual salaries more than double the national average for all occupations: $58,260. Here is a breakdown of median annual salary data for NPs and PAs, including salary percentiles and the top-paying employers.

Nurse Practitioner Salaries

The average yearly pay for nurse practitioners 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

The following were the highest paying employers and their yearly salaries for NPs:

  • Outpatient care centers: $128,190
  • Hospitals; state, local, and private: $128,190 per year
  • Offices of physicians: $121,280
  • Offices of other health practitioners: $104,790
  • Educational services; state, local, and private: $102,680

The figures above include salary data for three unique occupational NP titles.  According to (2022), nurse practitioners earned an average of $105,000 per year based on 1,074 self-reported profiles. 

Physician Assistant Salaries

The average yearly pay for physician assistants 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 work environments that offered the highest pay for PAs in were:

  • Outpatient care centers: $128,430 per year
  • Hospitals; state, local, and private:$127,240
  • Offices of physicians: $121,010
  • Government: $106,910
  • Educational services; state, local, and private: $101,040

According to (2022), physician assistants earned $100,699 per year based on 6,248 self-reported salary profiles. 

Most NPs and PAs work full-time during conventional business hours. However, it’s worth noting that NPs and PAs may have on-call shifts or be required to work unusual hours in specialized clinics, such as OB/GYN and emergency room settings.

Accredited Programs: NPs and PAs

NP and PA programs typically take two to three years to complete. Upon graduation from an accredited program, NP and PA students can take national certification exams. 

Programmatically accredited NP and PA programs provide comprehensive training that covers a wide range of topics, including medical history taking, physical examination, diagnostic testing, and pharmacology. In most states, NPs and PAs can only pursue licensure upon graduating from an accredited program. 

Nurse Practitioner Programs

NP graduate and doctoral programs are accredited by the Commission on Collegiate Nursing Education (CCNE) and the Accreditation Commission for Education in Nursing (ACEN).

Here are three nurse practitioner programs that confer master’s and doctoral degrees.

Colorado Technical University

The family nurse practitioner program at Colorado Technical University is designed to allow working nurses to continue their work within the community while advancing in their MSN degree. With an asynchronous classroom format, students can formulate a study schedule that they can incorporate into their professional life. Additionally, instructors provide synchronous chats to support varied adult learning needs. 

The program requires rigorous study and strong time management skills with dedicated daily reading and study time. Through the FNP program, nurses will develop the knowledge and skills necessary to provide quality care for patients and families.

  • Location: Colorado Springs, CO
  • Duration: 24 months
  • Accreditation: Commission on Collegiate Nursing Education (CCNE)  
  • Tuition: $36,720 per year

Texas Woman’s University 

The program at Texas Woman’s University is a master of science in nursing – family nurse practitioner degree program that consists of 14 courses and 45 credit hours. Students can complete the NP program in as little as two years full-time or 2.5 to three years part-time. 

NP students take 13-week courses, with three start dates per year (spring, summer, fall). NP students have three robust direct patient care experiences, and the program provides placement support services. Admission requirements for the program include holding a BSN degree from an accredited school of nursing, a 3.0 minimum GPA, and is a current, unencumbered registered nurse (RN) license holder.

  • Location: Denton, TX
  • Duration: Two to three years
  • Accreditation: Commission on Collegiate Nursing Education (CCNE) 
  • Tuition: $572.40 per credit-hour

Michigan State University

Michigan State University offers a hybrid nurse practitioner program that combines online learning with clinical simulations, face-to-face classroom activities, and community-based clinical practice experiences. All nurse practitioner program graduates qualify to take national clinical specialty certification exams. The first-time pass rate on the American Association of Nurse Practitioner Certification Board (AANPCB) clinical certification exams for 2021 FNP and AGNP program graduates was 100 percent. 

NP students pursuing an MSN at MSU may also progress directly into their doctor of nursing practice (DNP). The DNP program offers three specializations: adult gerontology primary care, psychiatric-mental health, and family nurse practitioner.

  • Location: East Lansing, MI
  • Duration: Two to three years
  • Accreditation: Commission on Collegiate Nursing Education (CCNE)  
  • Tuition: $817 per credit (residents); $1,606 per credit (non-residents)

Physician Assistant Programs

The Accreditation Review Commission on Education for the Physician Assistant (ARC-PA) accredits PA programs, including hybrid programs. 

Here are three physician associate programs at the master’s and doctoral levels. 

University of North Dakota 

The University of North Dakota’s master’s physician assistant studies (MPAS) program is a well-established PA program that offers online coursework and on-campus experiences. The program is 90 credit hours and is a hybrid of online and clinical rotations. The class size is 35 students, and the emphasis is on comprehensive primary care medicine. The program offers clinical rotations, which allow students to gain hands-on experience in the medical field. 

  • Location: Grand Forks, ND
  • Duration: Two years
  • Accreditation: Accreditation Review Commission on Education for the Physician Assistant (ARC-PA) 
  • Tuition: $499 per credit 

Yale School of Medicine 

The master of medical science (MMSc) in physician assistant studies program at Yale School of Medicine trains graduates to become patient-centered physician assistants. Students in this online program learn to diagnose and treat disease and illness by developing their communication skills and learning current treatment methodologies. 

Students attend class live through a virtual classroom, and topics are organized around human anatomy and physiology biological systems. . Coursework integrates pediatric, emergency, and geriatric medicine. In the second year of the PA program, students complete rotations in four different clinical settings.

  • Location: New Haven, CT
  • Duration: Two years
  • Accreditation: Accreditation Review Commission on Education for the Physician Assistant (ARC-PA) 
  • Tuition: $64,864 per year

University of Pittsburgh 

The doctor of PA Studies (DPAS) program at the University of Pittsburgh is a post-professional degree program specifically for PAs. The 42-credit program is designed to enhance career opportunities for practicing PAs and is based on the competencies of the PA profession. It consists of online courses culminating in a scholarly practice capstone project and defense. 

The DPAS program allows PAs to pursue a doctorate after completion of their master’s degree while remaining in their place of practice. PA studies have consistently shown that PAs with a doctorate can provide better patient care, and the DPAS program at the University of Pittsburgh is designed to enable PAs to achieve this level of excellence.

  • Location: Pittsburgh, PA
  • Duration: 27 months
  • Accreditation: Accreditation Review Commission on Education for the Physician Assistant (ARC-PA) 
  • Tuition: $98,619 total (residents); $115,759 total (non-residents)

Licensure & Certification: NPs and PAs

After completing an accredited NP or PA program, graduates are prepared to take licensure and certification exams required to work legally, enter the workforce, and provide high-quality patient care. All states require NPs and PAs to complete an accredited program and pass a national certification exam. 

NPs and PAs who pass their national certification exams can obtain state licensure. Once licensed, NPs and PAs are required to complete continuing education courses regularly to maintain their license. 

Nurse Practitioner Licensure & Certification

NP licensure requirements vary by state, but all states require NPs to have a minimum of a master’s degree in nursing. There are several NP national certification exams; two of the most common are administered by the American Nurses Credentialing Center (ANCC) and the American Academy of Nurse Practitioners (AANP).

There are several specialty certifications NPs can earn to bolster their training and credentials to benefit patients and providers. Here’s a list of specialty certifications for NPs: 

  • Adult-Gerontology Acute Care Nurse Practitioner (ACPCNP)
  • Adult-Gerontology Primary Care Nurse Practitioner (AGPCNP)
  • Certified Nephrology Nurse Practitioner (CNN-NP)
  • Certified Urologic Nurse Practitioner (CUNP)
  • Dermatology Certified Nurse Practitioner (DCNP)
  • Emergency Nurse Practitioner (ENP-BC)
  • Family Nurse Practitioner (FNP)
  • Neonatal Nurse Practitioner (NNP)
  • Pediatric Nurse Practitioner (PNP)
  • Psychiatric-Mental Health Nurse Practitioner (PMHNP)

Physician Assistant Licensure & Certification

To become licensed as a PA, candidates must graduate from an accredited PA program and pass the national PA certification exam administered by the National Commission on Certification of Physician Assistants (NCCPA). 

Finally, the Certificates of Added Qualifications (CAQ) are credentials that PAs can opt to earn in seven specialty areas: 

  • Cardiovascular & Thoracic Surgery
  • Emergency Medicine
  • Hospital Medicine
  • Nephrology
  • Orthopedic Surgery
  • Pediatrics
  • Psychiatry
Rachel Drummond

Rachel Drummond


Rachel Drummond is a freelance writer, educator, and yogini from Oregon. She’s taught English to international university students in the United States and Japan for more than a decade and has a master’s degree in education from the University of Oregon. A dedicated Ashtanga yoga practitioner, Rachel is interested in exploring the nuanced philosophical aspects of contemplative physical practices and how they apply in daily life. She writes about this topic among others on her blog (Instagram: @racheldrummondyoga).