For aspiring clinicians, the dream of treating patients can lead down a couple of paths: four years of medical school plus several years of residency, or two to three years in a physician associate program.
Pursuing a career as a medical doctor is more demanding in time, cost and depth of knowledge, while becoming a PA is a shorter — but still rigorous — path into clinical work.
Doctors are licensed to independently diagnose and treat patients and prescribe medications, while PAs make clinical decisions under the supervision of, or in collaboration with, a doctor.
Health care careers are evolving, and so are the titles. The American Academy of Physician Associates recently adopted the title “physician associate,” replacing the former title “physician assistant” to better reflect the responsibilities of the job.
As prospective students weigh their options between med school and a physician associate education, they should consider the time commitment, program costs and their goals in the health care field, experts say.
Time Commitment and Academic Rigor
Attending medical school is typically four years of in-depth study followed by three to eight years of residency, depending on the speciality.
PA programs are shorter — typically two to three years — and the curriculum focuses on practical skills for immediate patient care. Students typically take foundational medical science courses the first year and focus on clinical rotations the second, experts say.
“PAs learn a vast amount of information in a relatively short period and continue to build on that knowledge, which enables them to practice much sooner than a physician,” Reynold Jaglal, assistant clinical professor at Sacred Heart University in Connecticut and director and chair of the PA program, wrote in an email. “Ultimately, a physician may need to direct health care and often becomes the leader of a team, especially in specialties. However, the time to achieve that could be years.”
Medical doctors face long hours and varied call schedules throughout residency, as well as several days of USMLE testing to become licensed. Relocation also becomes a part of life: residency and fellowship spots are scarce, so the vast majority of med school graduates move far afield for specialty training.
The condensed path of PA education aims to have students quickly absorb medical information, apply it and transition into clinical settings.
Competitive Admissions
PA program admissions are not necessarily less competitive than M.D. programs.
Successful applicants to PA school had a median undergraduate GPA of about 3.6 — according to a 2024 Physician Assistant Education Association report based on 2022 data — compared to 3.86 among entering medical students in 2024, per Association of American Medical Colleges data.
According to the most recent data from the organizations, acceptance rates for medical school average 41.9% annually — although the most selective med schools accept fewer than 4% — while fewer than 40% of PA program applicants are accepted.
An important distinction: unlike med schools, PA programs don’t require the MCAT, the rigorous entrance exam to which med school applicants typically devote three to six months of intense study.
[Read: Is Medical School Right for You?]
Beyond GPA, PA programs look for students with health care experience, strong interviews and good interpersonal skills. Medical schools seek applicants with similar qualities, as well as strong MCAT scores and letters of recommendation, research skills, clinical experience and premed coursework, experts say.
Applying to medical school “requires applicants to be academically ready, to have a wealth of experiences, and many of them have service, research and so forth,” says Dr. Ioannis Koutroulis, associate dean of M.D. admissions at George Washington University’s School of Medicine and Health Sciences in Washington D.C.
Program Costs and Financial Aid Options
Program costs for PA school vary but average between about $112,000 and $125,000 for the degree, with in-state tuition often more affordable. Medical school typically costs anywhere from $200,000 to $400,000 depending on a number of factors — most notably whether you pay in-state or out-of-state tuition, experts say.
PA students “come out with less debt on average than medical students,” Jaglal notes.
On average, med students face more than $200,000 in student loan debt when they graduate, per the AAMC, while PA students have an average student loan debt of $112,000, per the AAPA website.
However, there are many ways to finance your medical education, such as exploring financial aid, grants and scholarship opportunities.
Salary
After residency, doctors typically earn higher salaries, which can help ease the burden of student loan repayments. In fact, M.D.s earned an average of $239,200 in 2024, significantly higher than the annual salary of the average PA that year — $133,260 — with some doctor subspecialties earning even more, according to U.S. Bureau of Labor Statistics data.
“You’re looking at higher salaries once residency is done, but (it’s) a lot longer before you begin earning high salaries,” says Dr. Alan Kadish, president of Touro University in New York and New York Medical College.
PAs are able to enter the workforce and start earning a professional salary much sooner.
Career Flexibility and Job Outlook
When choosing whether to pursue a PA program or med school, it’s important to consider what you’re interested in studying. Physician associates are trained as generalists, allowing them more flexibility when it comes to changing specialties.
PAs “can just become what we need, and that’s the power of being a PA,” says Todd Pickard, AAPA president and board chair.
Medical doctors, however, train in one specialty, allowing for deeper expertise in that area.
“It’s way more difficult for a physician to pivot from one specialty to another, if not impossible in some cases, because of the specialization and the amount of information that you need to learn for each of those specialties,” Koutroulis says.
Both careers are in high demand. But PA jobs are expected to grow 28% between 2023 and 2033, much faster than the projected 4% growth rate for medical doctors and surgeons, per BLS data.
Prospective PAs should note that the scope of their practice can depend on where they live — and may change if they move — since the amount of physician oversight required varies by state, by specialty, and sometimes by practice.
Which Path Is Better for You?
When making your decision, consider more than just tuition and timelines, experts advise. Choose the career that aligns with your medical interests and ambitions.
For example, you may choose medical school if you want greater autonomy or plan to establish your own practice.
If you seek greater flexibility and work-life balance, becoming a PA may be the better path, experts say. Especially in an outpatient setting, PA schedules are often more predictable.
Doctors and PAs work side by side, and both careers are highly respected and necessary, experts say.
“The team approach to health care has become more widely accepted and is really the way things are done these days,” Kadish says. “If used properly, PAs can be an extraordinarily valuable member of the team, provide great patient care and allow physicians to focus on the more highly specialized things.”
This collaborative model relies on communication, adaptability and a commitment to the common goal of patient care, experts say.
“Get back to what drives you because if you’re just chasing a check or a title, you’re going to not be happy,” Pickard says. “You have to have passion and purpose because that’s what drives us more than anything else.”
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PA School vs. Med School: What to Consider originally appeared on usnews.com
