“Health care is booming.”
You hear it when watching the news, listening to the radio, and even just in chatting with friends. It’s encouraging, because you’ve always pictured yourself working in a role that allows you to help improve peoples’ lives. And you’ll be happy to hear that rumors of a bright future for the industry are true.
According to the US Bureau of Labor Statistics (BLS), health care employment as a whole is projected to grow 14 percent through 2028. That includes careers ranging from physician to pharmacist.
Even though you know you want to work with patients in a clinical setting, you still have multiple occupational options. You’ve done some research to help you determine which roles might be the best fit. Now you’re weighing a specific choice: PA versus MD. You just need a little more information to help you figure out how to proceed.
In order to make your decision a little easier, we’re comparing the roles of a physician assistant and a medical doctor, or physician. Take a look at the distinctions to help you determine which career could be best aligned with your goals.
PA vs. MD: Different roles on the same team
Both physicians and physician assistants are intricately involved in patient care. They’re part of the same team, working collaboratively. There’s also considerable overlap for some of their duties, particularly in primary care settings.
"Where I work in family medicine, PAs and MDs see similar patients and do many of the same things."
“Where I work in family medicine, PAs and MDs see similar patients and do many of the same things, including conducting sick visits, physicals, and procedures,” explains Ann Marie Strong, Family Medicine Physician Assistant in Minneapolis, Minnesota.
Differences between the careers emerge when patients have complex cases. Physicians have more expertise treating less-common issues and are the only medical professionals licensed to perform surgeries, though PAs may be able to offer assistance during operations. And MDs can work more independently than PAs.
“The level of autonomy is a main difference and tends to differ based on the type of practice, the state, and the organizational structure,” notes Dr. Sylvie Stacy, Preventive Medicine Physician in Bessemer, Alabama and founder of an online community dedicated to helping medical professionals create fulfilling careers.
"The level of autonomy is a main difference and tends to differ based on the type of practice, the state, and the organizational structure."
State laws actually play a huge part in the scope of a PA’s job. The amount of physician supervision required, authority to write prescriptions, and specific ratio of physician assistants to physician can all vary depending on where you live. The American Medical Association (AMA) has a handy outline of the requirements in each state.
PA vs. MD: Education and training
The path to both roles starts with obtaining a four-year college degree. Future physician assistants then attend a two- to three-year PA program. Aspiring doctors will need to go to medical school for four years. It’s also worth noting that both education routes typically require applicants to complete specific science prerequisites and gain relevant experience. Both PA school and medical school focus heavily on clinical rotations during the latter portion of the curriculum.
Physician assistants can begin work soon after completing their education is complete, provided they pass the Physician Assistant National Certifying Exam (PANCE) and obtain a state license. They may choose to pursue additional training, but it’s not required.
“There are optional residencies,” Strong explains. “But most PAs round out their skills with on-the-job training.” That fast track is part of why she decided to pursue a career as a PA.
Physicians have a slightly longer road. After medical school, they need to complete three to seven years of postgraduate residency training. Those pursuing highly specialized areas of medicine will need to round out their resume with a fellowship as well. For the right person, the additional training after medical school can be an exciting opportunity.
"I really enjoyed the science of medicine and wanted the more in-depth training of medical school and residency."
“I really enjoyed the science of medicine and wanted the more in-depth training of medical school and residency,” Dr. Stacy reflects.
Physicians also have their own examination requirements. They’ll need to pass the three-part United States Medical Licensing Examination (USMLE) series, become board-certified, and obtain the appropriate state license. Both PAs and MDs are subject to continuing education and recertification requirements throughout their careers.
PA vs. MD: Salary and career outlook
We already mentioned that there’s significant demand for health care professionals in general, so it makes sense that the outlook is positive for PAs and MDs alike. Employment of physicians is expected to grow 8 percent through 2028, which is faster than the average for other occupations. Demand for physician assistants is even higher, with a projected growth of 31 percent through 2028.
Compensation is another point of divergence for PAs and MDs. The median annual salary for physician assistants in 2018 was $108,610. Doctors, on the other hand, earned a median annual wage of $208,000 or greater. These values can also fluctuate quite a bit depending on location, setting, experience, and specialty.
Some individuals even pursue an MD to open up the door to other careers. This was the case for Dr. Stacy.
"From what I’ve seen, MDs have a wider range of work options."
“From what I’ve seen, MDs have a wider range of work options, especially in medical or health care-related, non-clinical jobs, such as working for a pharmaceutical company or health insurance company,” she says. “Also, many organizations looking for medical leadership are looking specifically for MDs.”
PA vs. MD: Determining which is right for you
There are clearly advantages to both career options. If you’re feeling torn, then gaining some exposure can help. Strong recommends observing doctors and physician assistants in the workplace by setting up some job shadowing experiences. Students who are still in college, or who have yet to begin, are in a particularly good position to do this.
“The training is the same in college to begin with, so there is still time to figure it out,” Strong explains.
Even arranging some conversations with practicing PAs and MDs can be helpful. It may be a feasible way to learn from professionals who don’t accept requests to shadow, too. Dr. Stacy suggests speaking with professionals who work in a range of settings and types of organizations to get a well-rounded picture of both careers.
"See what resonates with your goals, both professionally and personally."
“See what resonates with your goals, both professionally and personally,” she advises.
The choice is yours
The PA-versus-MD decision is a common one for many aspiring medical professionals. Ultimately, you have to decide which career path aligns closest with your aspirations. Now that you have a little more information about both of these roles, you might have a better sense of which path to follow.
Education is clearly an important part of the process for both careers. If you’re thinking about becoming an MD, you’ll want to learn more about medical school. Find out if it’s right for you by checking out “Should I Go to Medical School? 7 Questions You Should Ask First.”
* This article has been updated from a previous version to include current facts and figures.
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