Physician assistant vs. nurse practitioner vs. medical doctor: What's the difference?
All three can evaluate patients, diagnose illness, order tests, develop treatment plans, and prescribe medication, but they reach practice through different educational pathways and operate under different licensing laws.
This comparison also includes registered nurses and medical assistants for context.
Quick answer: PAs complete a broad graduate medical education and more than 2,000 hours of clinical rotations. NPs first train as registered nurses, then complete population-focused graduate nursing education, with at least 750 direct patient-care clinical hours in accordance with current national quality standards. Physicians complete medical school, followed by three to eight years of required specialty training. Scope of practice for PAs and NPs varies by state.
Medical Assistant vs. RN vs. NP vs. PA vs. Physician
Programs, individual career paths, employer requirements, and state laws vary. The table summarizes the typical U.S. pathway and should not be read as a rule for every person or jurisdiction.
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| Category | Medical Assistant MA |
Registered Nurse RN |
Nurse Practitioner NP |
Physician Assistant/ Associate PA |
Physician MD or DO |
|---|---|---|---|---|---|
| Primary focus | Clinical and administrative support | Direct nursing care and coordination | Advanced nursing diagnosis and treatment | Medical diagnosis and treatment across specialties | Medical diagnosis and specialty care |
| Learning framework | Allied-health support | Nursing | Advanced-practice nursing | General medical | Medical plus specialty training |
| Typical education | Certificate or associate degree; some employer training | Nursing diploma, ADN, or BSN | RN preparation + NP master’s or doctorate | Bachelor’s + PA master’s; program usually ~27 months | Bachelor’s + 4-year MD/DO + residency |
| Typical time after high school | 1–2 years | 2–4 years | Usually 6+ years; pathways vary | Usually 6–7 years | 11–16 years |
| Clinical education | Varies; externship common | Varies by program and state rules | ≥750 direct patient-care hours in current quality standards | >2,000 clinical-rotation hours | Medical-school clerkships + 3–8-year residency |
| Postgraduate residency | None | Not required; employer programs optional | Optional | Optional | Required |
| Entry credential | Employer/state requirements vary; CMA optional | NCLEX-RN + state license | National NP certification + APRN license | PANCE + PA-C + state license | MD/DO + USMLE or COMLEX-USA + state license |
| Credential maintenance | CMA: 60 points or exam every 5 years | State-specific license renewal and CE | Board and state specific; AANPCB uses a 5-year cycle | 100 CME every 2 years + PANRE/PANRE-LA in 10-year cycle | State CME + specialty-board requirements |
| Practice authority | Delegated tasks; no independent diagnosis or prescribing | Nursing scope; no independent medical prescribing | Full, reduced, or restricted by state | State and practice-specific team requirements | Independent within license and credentials |
| National mean wage | $46,120 | $101,420 | $137,300 | $141,280 | $277,260 |
| Projected growth, 2024–2034 | 12% | 5% | 40% | 20% | 3% |
The salary row uses the latest national mean annual wages from the U.S. Bureau of Labor Statistics Occupational Employment and Wage Statistics survey, dated May 2025 and released in May 2026. These figures cover wage-and-salary employment and are not the same as starting salary, take-home pay, or total compensation. Location, specialty, experience, call, overtime, bonuses, and practice ownership can change earnings substantially.
Important: the physician figure combines multiple specialties. May 2025 BLS means ranged from $212,110 for general pediatricians and $255,820 for family medicine physicians to substantially higher figures in some procedural specialties. The combined physician figure is therefore not a promise of income for a particular specialty.
For a deeper look at PA compensation, see our 2026 physician assistant salary report.
PA vs. NP: What Is the Biggest Difference?
The clearest difference is the pathway into advanced clinical practice.
- NPs begin in nursing. They become registered nurses and then complete graduate education in a defined role and population focus, such as family, adult-gerontology, pediatrics, neonatal, women’s health/gender-related, or psychiatric-mental health.
- PAs enter through general medical education. Their graduate programs provide broad preparation across age groups and medical and surgical disciplines. PAs can move among specialties without completing a new entry-level degree, although employers may require orientation, experience, or additional training.
Both professions diagnose and treat illness, order and interpret tests, prescribe medication, counsel patients, and work in primary and specialty care. Neither title alone tells you how experienced a particular clinician is in a particular setting.
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PA vs. Physician: What Is the Biggest Difference?
The physician pathway is much longer and includes required postgraduate specialty training. The Association of American Medical Colleges estimates that becoming a physician typically requires 11 to 16 years: four years of college, four years of medical school, and three to eight years of residency.
Most PA programs take about 27 months after a bachelor’s degree and include more than 2,000 hours of rotations. PA postgraduate residencies and fellowships exist, but they are optional. This shorter, generalist pathway lets PAs enter practice sooner and change specialties more readily; it does not make PA and physician training interchangeable.
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A Surgeon Speaks: 7 Reasons Why You Should Choose PA Over MD
See also: PA vs. MD: understanding the differences, and Why my Wife is Happy I am a Physician Assistant and not an MD
👉 Torn Between PA or MD? Here’s How You Decide!
Can NPs and PAs Practice Independently?
A single national “yes” or “no” is inaccurate.
NP laws are commonly categorized as full, reduced, or restricted practice. In a full-practice jurisdiction, an NP can evaluate, diagnose, order and interpret tests, initiate treatment, and prescribe under the state board of nursing’s authority without a mandated physician contract. Other jurisdictions require a collaborative or supervisory relationship for some or all of those functions. The AANP state practice environment map is updated as laws change.
PA laws are also changing. Depending on the jurisdiction, the law may use supervision, collaboration, a practice agreement, or may eliminate a legally required relationship with a specific physician. Scope may also be determined at the practice level. The AAPA state practice environment map shows the current variation.
Legal authority is only one layer. Hospitals, clinics, payers, and credentialing bodies may impose additional requirements on NPs, PAs, and physicians.
Which Career Path Is Right for You?
Choose the role that matches the work and training pathway you want—not simply the largest salary number.
- Consider PA if you want graduate medical training, broad preparation, substantial supervised rotations, and flexibility to change specialties.
- Consider NP if you want to build on an RN foundation and practice within a defined population focus through the advanced nursing pathway.
- Consider physician if you want the deepest and longest medical and specialty training, full physician-level responsibility, and are prepared for medical school and residency.
- Consider RN if you are drawn to direct nursing care, patient education, care coordination, and a wide range of bedside and non-bedside roles.
- Consider medical assisting if you want a shorter entry pathway into hands-on clinical and administrative support work.
If the PA path fits you, use PA School Finder to compare programs and build your school list.
Sources and Methodology
This article was fact-checked on July 13, 2026. Wage figures are national mean annual wages from the May 2025 BLS Occupational Employment and Wage Statistics survey, released May 15, 2026. Employment growth uses the latest BLS 2024–2034 projections. Education, certification, and practice-authority details come from the relevant national professional, regulatory, accrediting, and certifying organizations.
- U.S. Bureau of Labor Statistics: May 2025 national employment and wage data
- BLS Occupational Outlook Handbook: Medical Assistants
- BLS Occupational Outlook Handbook: Registered Nurses
- BLS Occupational Outlook Handbook: Nurse Practitioners and other APRNs
- BLS Occupational Outlook Handbook: Physician Assistants
- BLS Occupational Outlook Handbook: Physicians and Surgeons
- National Task Force: 2022 Standards for Quality Nurse Practitioner Education
- National Council of State Boards of Nursing: APRN Consensus Model
- AANPCB: NP certification and renewal FAQs
- AAPA: Become a PA
- NCCPA: Maintain PA-C Certification
- AAMC: Education required for a career in medicine
- Federation of State Medical Boards: About physician licensure
- American Board of Medical Specialties: Staying board certified
- American Association of Medical Assistants: CMA recertification
Correction policy: because state practice acts and certification rules change, readers should verify current requirements with the applicable state board and certifying organization.
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Hi there, I am currently in college and interested in a job in the medical field. Physicians Assistant has peaked my interest due to the climbing job growth. How would I go about becoming one? For example, what classes should I take, degree should I pursue, would I go to med-school after completing my bachelors? Your insight would be much appreciated!
Sierra,
I am currently a Pre-Med student at an undergraduate instituion and I know a few pre-PA students. Firstly, you should get in contact with your Pre-Health Professions Advisor, he/she will help you with the process. Most (if not all) PA programs require a Bachelor’s Degree; Biology and Medical Laboratory Sciences are popular however you can major in anything. You do have to make sure to take all the pre-reqs. Check with admissions with the schools that you are interested in. PA school I believe is 2 years.
Hi Beau,
Wonderful advice. And you are right – soon all schools will require applicants so have a bachelors degree prior to application and most schools are 2 years there are still some 3 year programs out there. There are also a lot of 3 + 2 programs which combine undergrad with a direct admission graduate program and the list is growing.
– Stephen
Super helpful, thanks Stephen!
Thanks Anh!
I wanted to be a doctor but the stress the years and the expense is too much so I’m considering nursing or physician assisting
Both wonderful options with an exceptional job outlook combined with an excellent work life balance!
Stephen
I’ve been looking for something that broke down the NP vs. PA, and this is the best chart out there, thank you!
I am doing a report on Surgical Nurse practitioners, which is what I am thinking about pursuing in the future, and I need help finding people to interview and maybe shadow if I could in my area.. Could you possibly help me? Thank You!
Hi Ashley,
I would contact Erin over at Midlevel-U – her blog is geared toward NPs and she may have some connections for you http://midlevelu.com/contact
– Stephen
Hello! I am an aspiring PA and I have a few questions about being a physician assistant.
1) How do you address a PA in a professional setting? Doctors are addressed as “Doctor ____”; Nurses are addressed as “Nurse _____” So what about PAs? Do people refer them as “PA ______” or “Mr/Ms/Mrs ______”?
2) What can PAs do with a doctorate and what do they get their doctoral degree in? Will they be considered ‘overqualified’ if they have a doctorate and have to resort to teaching?
3) If a PA does have a doctorate, then are they called “Doctor ____” instead? Will that confuse patients?
I realize that these questions are a bit strange, but I do think of them often and have not yet been able to find answers.
Thank you so much! 🙂
Great questions Catherine and no they are not strange at all!
1. I am often referred to by my first name “Stephen”, and when the front desk staff address me they will say the same thing, “you have an appointment with Stephen” or if the patient is new to our clinic or doesn’t know me they will say “you have an appointment with Dr. Li’s physician assistant, Stephen.” Many patients will call me Doctor Stephen and no matter how many times I correct them, they continue to use the term doctor, usually after several years of begging and pleading I simply throw in the towel give up 🙂
2 and 3: I think a doctorate of PA is very confusing for this exact reason, it is also unnecessary. Many NP programs are starting to award doctorate degrees and there has even been talk about converting all NP programs to doctorate level programs. We would still be called PAs regardless of the level of our degree (just like bachelors or masters level PAs) and I guess if you felt so inclined you could add a few more credentials to your name on your lab coat. In my opinion this is overkill but some people just can’t get enough of it I guess.
Hope that helps,
– Stephen
Thank you so much!!!
-Catherine
Orthodoc77…never heard of Elizabeth Kennedy? I’m assuming you send your patients to PT on a regular basis. Nurses have been responsible for many innovative and useful treatments throughout history and your statement is not only offensive but inaccurate. NPs focus on holistic care of the patient. They don’t care to be your “equal” they care about doing what is best for a patient. All of the practitioners I know, PAs included, know their limitations and are happy to call in the MD when needed.
Family medicine doctors do not perform surgery.(surgical residency required and a huge salary boost). And nurses (RN’s) can first assist if trained in an expanded role as a RNFA. Nurse practitioners also need to be certified RNFA’s in most states to first assist and bill. This info was not found in your article.
On the other hand I have experience of getting medical training through my teen years in the care of others and later in special medical school and training. Thus I know from personal experience as a patient and working in the medical field as well as other types of care giving, many are behind the scenes and are somewhat like a great engine under the hood of a very expensive vehicle that gives it the power to win the most difficult races, thus saving lives and giving back suck bodies health, steength, and longevity of life, which otherwise would have been taken from them by laws of nature. E. T.
Thanks for the table. It does not comprehensively reflect the credentialing, licensing, maintenance of certification, malpractice, and other expenses of a physician. To the person above noting that NP’s get experience prior to starting training, please note that so do most MD’s (many shadow or volunteer in clinics for 1-2yrs before starting training), and that many MD’s also get MPH’s or PHDs as well.
Anyone remarking about physician salary should remember that residents (this is non-optional, non-negotiable, and can still easily exceed >80H/wk training for 3-8yrs AFTER medical school) make approximately minimum wage, while repaying on average almost $200k (pre-compounding) of student loans, and deferring retirement savings or starting families. There is not an option to take time off, take most holidays off, stay home sick, sleep nights, unionize, etc. *****Economic studies show that the average primary care physician nets a lifetime income just BELOW a public high school teacher.***** Physicians assume the ultimate liability and targets (obgyns and surgeons can spend $100k/yr in malpractice insurance), and in private practice models they cover all the overhead and employee expenses too (including matching healthcare and retirement plans). For the majority of physicians, they are NOT getting rich, nor is it why they went into medicine, nor are they being treated particularly better than their non-physician colleagues.
I am so thankful for good nurses, PA’s, and NP’s. I am also so tired of everyone saying that they are nearly physicians, can do most of what physicians do (the simpler / safer parts, when they can tell the difference, and when they can’t, Lord help us all), or discrediting physician’s training and commitment. Every day someone is posting on social media about how great nurses are (it’s true) and ranting about how inept / greedy / whatever doctors are (why?). Anyone who wants to be a medical doctor can go to med school, and take on everything that means (good or bad). Everyone else can acknowledge that their training, while potentially very lengthy and meaningful, is NOT equivalent.
Thanks for listening.
Hi RS,
I really enjoyed what you had to say, in fact it makes me appreciate doctors even more for all their hard work and dedication to the profession! As PAs we wouldn’t have a profession without supportive and passionate MDs who care deeply for the patients and the work they do. That goes for all healthcare professional or anybody who dedicates their life to the wellbeing of others. Again, I appreciate your info here, and I will use it to take a moment and give a shout out to all the MDs out there!!!
– Stephen
As a patient I feel that too many doctors, nurses, and assistances have attitudes and treat patients as if they are dummies and void of any knowledge of their own bodies and the health conditions patients have to live with every day of their illness or conditions, sometimes weeks, months, or years which with some is a lifetime condition or conditions. Yet health providers have a tendency to fall into the same trap of treating patients as if patients are just a blurr of everyday activity necessary to make a living in their chosen lifestyles. Includes others working within the medical system.
I would have to definitely agree.
I worked as a nurse prior to having a stroke and now I am on disability. I have many health issues, including chronic pancreatitis (idiopathic), high b.p., type 1 diabetes (due to 90% pancreatectomy), & as noted above, a bilateral watershed stroke. Needless to say more than anything, I have been in and out of the hospital so much because of the usual acute on chronic pancreatitis, that I actually know most of the ER doctors nurses, nurse assistants, the dietary staff, and even the housekeepers. Sometimes I am treated well, and other times I am made to feel like the “frequent flyer”, or am there to only receive pain medication. In most cases, my labs usually show up normal (mainly due to my lipase and amylase levels, due to “bottoming out”, which mostly stumps the doctor’s.)
I spent 3 years in and out of the hospital PRIOR to having the pancreatectomy with physicians not catching that I had stones in my pancreas. Finally, after a long haul of unknowns, I had surgery, and in which the surgeon told me how diseases it really was.
….Now, I still have fits with my remaining pancreas, which usual sends me to the ER at least every 2 months.
I hate having to show up “again” there. It makes me feel inadequate as it is, and then I may have one of those “oh no, she’s here again” nurses, or assistants, and that makes me feel even worse.
To conclude my rant, I would like to say that individuals who work in health care should have the compassion that most took oath to do. Before I have even arrived at the hospital, I usually have gone through utter hell by the vicious vomiting and sweating spells, the severe pain, the weakness from the inability to eat, that even combing your hair is a huge undertaking. As a patient, I don’t need to be made to feel any less of a person, or that I am just a blurr in their everyday activities, or be thrown an attitude because I Am frequently there. There’s no doubt that they have cooky patients, (Lord knows I had mine), but even they deserve adequate and proper care with compassion.
It makes me wonder how they would feel if it was them.
An outstanding post. I think many healthcare staff become ‘task oriented’ and forget the reason they chose this profession in the first place…to give outstanding, patient centered care (hopefully that was the reason). Each and every patient deserves to feel respected and cared for, regardless of how many times, or whatever the reason they visit the hospital. Thank you for the reminder.
Hi E.T.
I have seen this attitude many times both in the hospital and in the clinic, it is always unfortunate. I often wonder if this is simply a byproduct of a broken system? Most practitioners I know went into medicine because they wanted to help people, although there are some who are doing it out of a feeling of responsibility, or they were on a medial track for so long they just kept going despite the fact they didn’t have a passion for it. I know many wonderful providers, so if you are in a situation where you feel you are not receiving good care find a medical home that is supportive and stick with it. In the ER or in the hospital this can be a bit more challenging and can be more “the luck of the draw”. As in most professions there are good eggs and rotten eggs and you will come accross both in your life. Thank you for sharing this, I know everyone can relate!
– Stephen
Economics studies?! Please cite thes studies because the math has to be wrong. Where I live high school teachers start out at a salary of 27,000 and top out on the scale after 15 years of experience and a Ph.D. At 69,000 there is no way that an M.D. Makes less than the average teacher. P.s. We have student loans to pay off to! That P.h.d didn’t come free!
i am a high school student and i am writing to you because we are studying ethics and we were given a question to debate about and i was wondering what your thoughts were my question is ” with primary care increasingly being provided by nurse practitioners and physicians assistants will more medical mistakes be made in contrast to a primary care physician
I like to go by hard data over speculation, and the hard data suggests that mid-level providers (specifically PAs) have some of the lowest malpractice rates in the business. Will this change as supervision gets worse and more PAs and NPs flood into the system with less supervision? I think this remains to be seen and it is a good question. Technology might just come to the rescue here as well! Personally, I think mid levels will continue to bring malpractice rates down in primary care.
– Stephen
While I appreciate your insight that lower supervision may effect quality, to say that low malpractice rates are a reflect a high quality of care is a making a huge leap. Let’s be real, the reason mid-levels have lower rates for malpractice is because they aren’t the ones getting sued. So the malpractice insurance companies take less of a risk covering them and thus premiums are lower. Until the last few years all NPs/PAs were overseen by a physician so who do you think the lawyers go after – the physican because they are the one ultimately responsible and they have deeper pockets.
Want to clear up a couple of things
#1. Nursing time in classroom is the same as any bachelors program. The united States Credit system specifies that a certain amount of credits are required to earn a bachelors degree. 10 credits = 10 hours of classroom time a week. Almost every bachelors degree in the united states require at least 120 credit hours. This varies a little by institution and degree but any accredited requires at least 120 credit hours total. PA’s and MD typically get their bachelors degree In biology or chemistry or some other science field. Nursing bachelor degree is in nursing the Difference is Subject matter. Nursing dives into pathophysiology, pharmacology right away in their bachelors programs. MD and PA.. they typically don’t study these things in their bachelors programs but they come later in PA masters programs or MD medical school.
#2 Nursing and NP Clinical hours do vary based on programs and state requirements. Many programs are require more than state minimum. Also, To even apply to NP school you are required to have 2 years experience. Most schools do not accept students with much less than 5 years of experience. I don’t see that in the table. CRNA is even more competitive.
#3 NP (50%) and PA programs are both masters degrees require around 30 credit hours of course work. Remember credit hours are calculated by the number of classroom hours. Not sure where they are coming put with 500 NP vs 1000 PA classroom hours. Also, 50% of NP Schools now require the doctorate degree for NP’s however national certification does not require it YET.
#4 Can someone explain to me the difference between nursing model and physician model? This is a misnomer. Basically it boils down to a Nurse is not allowed to “diagnose” ( only doctors do that i guess ). So instead of charting hypertension a nurse must document ” high blood pressure” instead. Hypertension is a diagnosis, high blood pressure is a symptom. NP’s aren not trained on a ” nursing model ” whatever that is. NP’s are trained in holistic (whole person approach) but use the same medical diagnosis as PA’s and MD. IE: NP are trained not to focus on the disease itself.
#5 Most Bachelor Degree prepared Nurses have an additional 800-1200 clinical hours in addition to class room work. NP do require any where from 500-1500 of clinical work as well depending on speciality but remember it also requires at least years of experience before even applying to school which is about 2000 hours of work for each year of experience.
#6 There are options for NP’s to do a Fellowship / Residency program. ( not very many ) but I am hoping for more
#7 21 states including the district of columbia allow NP’s to practice independently of physicians. Some even allow them to own their own clinic and hire physicians. In these states NP is not tied to any physician oversight. BTW this is a good thing. Physicians if your PA gets sued they can come after you as well given that your ” overseeing ” them. That would not happen with and independent NP.
#8 Know this that NP’s / PA / and MD are trained differently. NP start their ” applicable medical education” much earlier in their scholastic career with in their bachelor program Pharmacology, Pathophysiology, Anatomy and Physiology are all requirements for a bachelors of nursing degree then in graduate school these courses are taken again an reinforced and expanded upon in greater detail to help diagnose and treat these disease with in the NP’s master / doctorate program. While PA’s and MD are focusing much more on biology and chemistry in their bachelors program. NPs take these classes too but not quite as many. The bulk of ” applicable medical knowledge” for MD,s and PA, Are in Med school and PA school.
Bottom line. I feel the NP route is a more efficient way to educate a clinician. How much biology and chemistry do you really need or will cary with you. There is no evidence to support that an MD/NP/PA have better outcomes on patient care. At this time I am not in favor of the doctorate programs because I don’t think they require any additional clinical acumen. If they did then I would fully support them. I also feel that NP and PA should have more residency programs.
Additionally: I did notice the salary discrepancy between Physicians and PA/NP’s. Interestingly the salary is nearly 50% of what a physician makes. Yet When an NP/PA bills a procedure or examination he/she gets reimbursed at 85% of what a physician would bill for. So why are not the salaries of NP/PA’s closer to 85% of a physicians salary. Just something to think about. ( Do you think they should be? )
I will like address some of the opinions you have expressed above;
1) The education that a physician receives is no where comparable to a nurses or NP, in depth or rigor. While some of the courses taken by both may have similar titles, the complexity is not the same and that makes a difference; meaning that a physician may have larger spectrum of differential diagnoses, than the NP. This makes his investigation thorough and exhaustive.
2) A lot of the NP programs are offered online and students are often left to find clinical slots by themselves. Preceptors are often not vetted; this leads to non standardization of education.
3) A lot of medical students have lots of medical experience prior to medical school ( paramedics, RT’s even nurses).. therefore prior medical experience is not exclusive to NP’s.
4) The financial burden of becoming a physician is staggering compared to that of the NP, so pay will never be equal.
In summary the NP and physician have separate roles to play, they may overlap but let me restate that they are not equivalent, in knowledge, expertise or mastery.
Also the bare minimum required to diagnose is not what has allowed for break through and advancement in medicine. It is that in depth knowledge of the sciences which starts at the undergraduate level that allows for innovation. When was the last time you heard of a NP finding some cure or break through therapy? that would be never! You may try to play doctor but the truth is till you go through the process you are not an equal!
This has to be the most opinionated and idiotic statement here. You have no basis of comparison (since you never took either the RN or NP classes) and yet you imply that med school classes are harder than RN/NP classes. Also, while some may go into medical school with experience, it’s not required so that is irrelevant.
On top of this, in the 100s of studies performed, they found no decrease in level of care provided by a NP vs MD in independent practices. Therefore, they are not “playing doctor”. They are primary care providers just like MDs.
In my opinion, your residency you keep talking about is irrelevant. NP requiring 2 -5 years of work is no different than MD requiring 2+ years of residency. They are both just practical experience in the same setting. The only difference is the POV. NP experience falls back on their belief in wholistic approach from their POV.
In a primary care setting, it won’t make a difference and the experience has been proven to be equivalent (outside of your elitist opinion). In other settings, it depends on the additional training provided in each field. There is no one way to learn information or a set of skills.
In other words, your opinion is just that. You are an elitist who believes a certain field is better than another just because they are in it. If you are a doctor, it’s a scary thought that you are refuting information without any facts. Adam made factual points. You provided nothing but opinions.
Joe,
I always find the ideas of “hardness” or “easiness” to be too subjective to be useful for describing things like this anyway. This semester alone I have made high 90s on every test in a class that consistent gets listed as “one of the hardest classes” in our department. I happen to love it! Is it “easy”? I don’t really know because I’m not really certain what that is supposed to me, I guess. Is it super hard? I don’t think so, but again what is this supposed to really mean.
Meanwhile, if you put me a drawing class I would probably find this to be very hard (I do well to make a stick figure that has a straight back LOL).
So, I certainly agree with you that comparisons between classes as “hard” or not is not really relevant.
When it comes to class material . . . well sure some classes cover more topics, or topics more in depth, etc., than others, but, again, I don’t know that this makes a class harder or easier.
Adam,
I did want to make just one comment about your point #1. The number of hours in class does not always translate directly to credit hours. We tend to think it does because this is usually the case with lecture classes. However, there are many lab classes that require 3 or more hours in lab each week that only award 1 credit hour. This has a lot to do with this somewhat outdated idea that “labs” are simply “extensions” of a lecture class. This might have been the case at one time, but most of the time these days labs add knowledge not simply reinforce the knowledge already added in lecture. Therefore, if a person took, let’s say, Biology 1, for 3 credits, and associated Lab, for 1 credit – for a grand total of 4 credits – it would be erroneous in most cases to state that this person spent 4 hours in a classroom or lab each week to get these 4 credits. The labs with my general biology classes were 3 hours each week, so that meant total in class time per week (lecture and lab) was 6 hours not 4.
Of course, the time spent in class itself says nothing about the quality of education, toughness of the material, level of education, etc. that one gains from those courses.
Adam,
I also meant to add some information about your #4 above. The term “nursing model of care” is actually one that originated with the nursing profession. There are actually several different “nursing models of care” to be exact. The American Nurses Association also acknowledges this. True, some people have used this derogatorily against NPs, but the term “medical model of care” has also been used derogatorily as well. My point is that bickering over the use of a specific term is kind of pointless. Most NP programs would say they train NPs in the “medical model” because they will be involved in diagnosis, etc. (and to be clear, there is a world of difference between saying someone has high blood pressure and differentiating a diagnosis of hypertension – not to mention determining the cause and best course of treatment for that hypertension).
As I said in my other response, you have to be careful assuming that similar class titles and hours imply a certain level of education or quality much less that it implies the same material. Every NP program I have looked at (and I have looked at a lot) require Advanced Pathophysiology (or some similar type class) and Advanced Pharmacology (or, again, some similar type class). If the Pathophysiology and Pharmacology classes taken in undergraduate nursing degrees was on par with the NP level then there would be no need to require these “advanced” classes. It is just simply untruthful to state that undergraduate classes and graduate-level (or professional-level) classes are identical (true, some upper-level undergraduate classes are sometimes offered as lower level graduate degree classes, but, even so, this doesn’t imply that the material is identical to upper-level graduate courses dealing with the subject).
Again, it is true that many pre-meds (myself included) major in biology, chemistry, or one of the sciences, but, again, it is erroneous to assume that, for example, the level of understanding of cell biology required by a nursing student is the same as that required by a biology student. Sure, there may be nursing students who have taken upper level cell biology courses, etc., but it is not required. This is not to imply that any one set of students is “smarter” than the other (and most certainly not that one set is “dumber” than the other). Rather, it is simply intended to point out that there is different knowledge required for students in different degrees and different classes. It doesn’t serve any side in the debate, discussion, etc. to make statements that imply otherwise.
This data needs to be updated.
There are only 18 states that allow NPs to practice independantly, you state MOST should be SOME.
PAs can prescribe controll II-V in MOST states.
Thanks Randall, I went ahead and updated the table based on your recommendations. I appreciate your input!
– Stephen
NPs are not planning to transition to a doctorate level degree this year. There are plenty of masters level programs that have been around for a long time and will continue to be around for a long time. The myth of NP going to doctorate level education is just that-a myth.
That is good to hear, I don’t particularly like the idea of a doctorate level NP degree or PA degree but I know there are many advocates of this. To me it just makes things confusing, and there is no advantage that I can see.
– Stephen
Stephen,
It also allows the schools to bring in more money off of the students. You have said elsewhere that one of the pluses to PAs is that they can afford to provide care to patients that many times, sadly, physicians cannot. I completely agree with you here that this is a plus. If we make every provider a “doctor” then we, along with that, increase the time in school, which increases the student loan debt, and that ultimately means that NPs and PAs can no longer afford to offer care to the under-served. This doesn’t mean that I think NPs and PAs are lesser people, or that they deserve to make pennies. Far from it in fact. It is also important to point out, however, that those with lower student loans can actually keep a lot more of the money they earn as well. That is a point I think a lot of people miss. Not to mention that many of the DNP programs I have seen add more social science type classes, and statistical research type classes, to the degree. This is not in itself bad, but the DNP doesn’t, in many cases, add any clinically-relevant course material. The social science type classes they do add are, in addition, often charged at the higher Nurse Practitioner tuition rate. My point? Many of these classes could be taken for a lot less as simply part of a graduate school, the NP could still benefit from the knowledge, and they could do so for a lot less money. Again, call me cynical, but I see the move to DNP as more of money grab on the part of the schools than anything (again, this is not meant rude at all to those people who have one or who just wanted to earn the DNP, etc.).
It is not my intent to offend anyone with this assessment, however.
Thank You PA Pasquini. I will be giving a talk to some high school students and this chart is MOST helpful. Thank you for taking the time to compose such a visual.
Thank you Dr. W… It is great that you are going to be speaking about this topic in high school. It is an eye opener for many students to know that there are options beyond medical school.
– Stephen
Thanks for the interest in the profession.
Interesting comparison, thank you