For students interested in practicing medicine, becoming a doctor or a physician associate are two common options. Both paths lead to patient care, but they differ in training length, responsibility, career flexibility and salary.
“Medicine is one of many meaningful health professions, each contributing uniquely to patient care, access and system effectiveness,” says Lisa Howley, senior director of transforming medical education for the Association of American Medical Colleges, a nonprofit representing U.S. medical schools, teaching hospitals and academic medicine.
What’s the Difference Between a PA and a Doctor?
Medical doctors, doctors of osteopathic medicine and PAs “diagnose illness, develop treatment plans, prescribe medications and provide patient care,” Howley says.
PAs, previously called physician assistants, practice in collaboration with physicians, with their responsibilities determined by state regulations and health system policies.
“All professions require a commitment to lifelong learning and a willingness to adapt to a dynamic career of service,” Howley says.
Here are some things to consider when choosing between becoming a PA or doctor.
Education and Training Requirements
Physician associates complete a bachelor’s degree and a master’s-level PA program, which generally takes three academic years and includes classroom instruction and more than 2,000 hours of clinical rotations.
“My experience with PA training was intense. I was treated no differently than the medical students on my team,” says Todd Pickard, president and chair of the board at the American Academy of Physician Associates.
Pickard says his decision to become a physician associate was shaped by a PA he encountered when growing up. The PA’s patient-centered approach stood out even alongside the doctors on his care team, Pickard recalls.
“PA programs are competitive and academically demanding,” he says.
Incoming PA students average more than 3,000 hours of direct patient care experience, often gained as paramedics, athletic trainers or medical assistants, Pickard says.
Medical doctors typically complete four years of medical school, three to seven years of residency and often a fellowship, “preparing them for independent practice, specialty leadership, and ultimate clinical responsibility for complex decision-making,” Howley says.
Scope of Practice and Career Flexibility
Despite overlapping clinical duties, physicians and physician associates differ in autonomy and career flexibility.
“While both evaluate and treat patients, the complexity and severity of the cases they manage are often different,” says Andy Swanson, chief revenue officer at Medical Group Management Association, a nonprofit that represents medical practice leaders. “PAs typically practice in collaboration with and under the supervision of physicians.”
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Doctors and PAs alike have good career opportunities and offer valuable contributions to health care teams and the ability to care for patients, says Suhas Babu, a medical student at Kansas City University in Missouri.
“I chose the physician pathway, as it allows me more autonomy in my clinical practice and the ability to lead health care teams in patient care,” says Babu, who is co-founder of The Premed Scene, a nonprofit platform supporting pre-health students.
Career flexibility can be a deciding factor for some students.
“Both professions are in high demand,” Swanson says. “PAs can practice in different settings, surgical or primary care, without having to go back through added programs.”
For doctors looking to switch specialties, such as going from internal medicine to cardiology, “they will have to go through another residency program,” Swanson says.
Students seeking top leadership roles should consider their options.
“Historically, the most senior leadership opportunities in health systems and large medical groups have been reserved for physicians,” says Tony Stajduhar, former president of Jackson Physician Search and an MGMA board member. “However, supervisory and leadership opportunities for PAs are becoming increasingly common.”
Pay, Job Outlook and Work-Life Balance
Differences in areas from career outlook to work-life balance are central to how the two professions compare.
The U.S. Bureau of Labor Statistics projects 20% growth in the number of physician associates between 2024 and 2034, compared to 3% for physicians and surgeons.
PAs commonly earn a six-figure salary. According to the Bureau of Labor Statistics, the average annual salary for PAs in 2024 was $136,900. In comparison, physicians and surgeons made an average of at least $272,320 and $354,760 per year, respectively.
“Both physician associates and physicians have lengthy career trajectories in clinical care, contingent on ongoing training and recertification and licensure,” Stajduhar says.
High demand and a limited clinician supply support strong job mobility in both fields, he says.
Work-life balance favors PAs, Swanson says, “though physicians have made significant strides in improving balance over the past decade.”
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Which Path Is the Better Fit?
The right choice depends on individual goals and priorities, experts say.
“For students unsure of what path to pursue, look into reaching out to physicians and PAs in different clinical settings, opportunity cost of both careers and reflect on what interests you in each pathway and why,” Babu says.
A common misconception is that becoming a PA is easy, Stajduhar says. “It isn’t. There are limited numbers of seats in graduate education for both PAs and physicians. Simply qualifying to apply to either training path is an accomplishment.”
A major misstep is focusing on the quickest path forward rather than the next 30 years of clinical practice.
“These are lucrative professions, but they come with real trade-offs,” Stajduhar says, such as irregular hours, emotionally demanding patient care and costly training.
“Patient care is a noble endeavor,” he says, “and the level of care one provides, in either the role of physician or physician associate, is both daunting but rewarding. Consider all factors.”
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Should You Become a Physician Associate or Doctor? originally appeared on usnews.com
