Physician Assistant

PA vs MD: The Key Differences (And What’s Right For You)

By March 26, 2020 April 4th, 2020 No Comments
PA vs MD Badges

If you are interested in practicing healthcare, you may think there is only one path—medical school. However, before making your decision, you should compare and contrast the programs and practices of an MD vs a PA.

To do so, start by considering the key differences between the professions while also evaluating your own personal goals and desires.

You’ll want to actively evaluate what you can achieve in the different roles against your personal and professional goals. For some, it may be necessary to have the “MD” after your name, while others may be professionally satisfied providing patient care as a PA.

Before making the decision to apply to medical school or a PA program, do some in-depth research in the chosen field, to ensure that it is the direction you truly want to take.

This research should include getting hands-on patient care, interviewing healthcare providers, and shadowing medical professionals. Shadowing looks good on your application, and it’s a great way to find out the different areas of medicine you may be interested in pursuing.

When deciding on which route is right for you, it’s necessary to first compare the programs, looking at the different levels of education, preparation, and cost involved in being a medical student or joining a physician assistant program.

After that, it’s best to analyze the different lives that the professions lead. From there, you should be able to decide which is best for you.

PA vs MD: Schooling

You have an advantage if you start investigating your medical professional options while in high school. When choosing classes to take, consider a course load heavy in the sciences.

A Backpack and a microscope

Both physician assistant and medical doctor career paths start with a four-year college degree, and both post-graduate programs look for students who have taken a lot of physical science classes. Not many colleges have a set pre-PA program, but most have a pre-med program that will meet the needs of PA school.

Admission Requirements: PA School vs Medical School

Admission requirements for PA school and medical school are similar, but not identical.

PA School Admissions

PA school admission committees look for potential PA students who have a 3.47 minimum GPA in their science classes and a minimum of 3.5 GPA in their non-science classes.

A unique pre-req for most PA schools is 2,000 hours of hands-on healthcare experience, and even when it’s not required, the hours make you a highly competitive candidate. These 2,000 hours equate to one year of full-time work, which you can spread over two to three years by working part-time during your undergraduate degree.

Some of the fields that are typically accepted for your 2,000 hours include EMT (emergency medicine), registered nurse, emergency room technician, medical assistant, medical technologist, chiropractic assistant, or respiratory therapist.

A unique position to consider for your healthcare experience is a medical scribe. These are paraprofessionals who specialize in supporting physicians, including charting patient interactions in real time. It is an uncommon opportunity to learn patient care.

PA programs are interested in your paid healthcare experience, so taking care of family members will not meet your need for clinical experience. In the same way, shadowing a physician, conducting research, or pre-employment training will not meet the needs of your PA application.

Many PA schools believe that your healthcare experience is a predictor of success as it helps prepare you for the program and the demands of working in a healthcare setting, which is why it’s so important to have valid clinical experience.

In addition to your GPA and healthcare experience, PA programs seek students with at least a 310 on the GRE. Taking the MCAT is optional.

Med School Admissions

For a competitive application to medical school you need higher grades and less healthcare experience than you do for PA school. A minimum acceptable GPA for an MD program is 3.64 in your science classes and 3.78 in your non-science classes, for an overall 3.71 GPA. Compare this to the desired 3.49 GPA for PA school, and you see that med school has more rigorous academic standards.

Though PA programs require the GRE with an optional MCAT, med schools are the opposite with a required MCAT and an optional GRE. To apply to an MD program, you need at least a 508 on your MCAT.

Healthcare experience is another variant between programs. While healthcare experience is necessary to apply for PA schools, it’s seen as a plus but not required by most medical schools.

Programs: PA School vs Med School

As you’re considering your professional options, it’s helpful to compare programs and costs to weigh this against your life goals and how you’d like to use your education. Let’s look at some of the similarities and differences.

PA School Education

Schooling may take two to three years to complete. The amount of time it takes depends on how your PA program is structured. Toward the middle of the program, you begin to focus on clinical rotations, which give you hands-on experience and expand on your classroom education.

Education in PA school is generalized, which provides you with general knowledge in a wide variety of topics, so you can choose a specialty and clinical rotation that most appeals to you after you graduate.

A generalized education also increases your flexibility throughout your career as many PAs go on to work in more than one specialty before they retire. You are able to start practicing once you graduate, pass the Physician Assistant National Certifying Exam (PANCE), and get your state license.

Medical School Education

Medical school is a four-year program after completing a bachelor’s degree. Just like in a PA program, med school coursework also includes a clinical rotation focus that begins in the middle of the program.

After graduating from medical school, you must complete three to seven years of a postgraduate residency program before you are able to practice. If you want to practice in a subspecialty, such as pediatric pulmonology, you may have an additional fellowship program.

Once you complete your residency and possible fellowship, you’re still unable to practice until you pass a three-part United States Medical Licensing Examination (USMLE) series, board certifications, and get your state license.

Cost: PA Program vs Med School

PA School Cost

The average cost for a PA program ranges from $70,000 to $90,000. The difference in cost depends upon the school you attend, where the school is located, and if you can take advantage of in-state residency tuition.

Medical School Costs

The average cost of med school is significantly higher than PA school, ranging from $200,000 to $300,000. The cost of medical school, again, depends on whether you attend a public or private institution, the area of the country where the school is located, and whether or not you can take advantage of in-state tuition.

Scope of Practice: PAs vs MDs

Your scope of practice is defined by the state legislature and regulatory bodies. These institutions define the procedures, actions, and processes any medical professional is allowed to perform under their professional license. The scope of practice for a medical doctor varies from that of a mid-level practitioner, like a physician assistant.

Stethoscope imageMD Scope of Practice & Flexibility

MD school graduates experience a different type of flexibility in their scope of practice than physician’s assistants or nurse practitioners, both mid-level healthcare providers.

Practicing under an MD license allows a physician to work independently of any immediate oversight and to own their own business. Since their education is specific to one specialty, and it requires additional years of training to switch, most physicians don’t change specialties during their career.

PA Scope of Practice & Flexibility

A physician assistant enjoys a different type of flexibility in their practice. For instance to practice as a PA, all states require you to collaborate with a physician. However, this does not mean you see patients with your collaborating physician hovering over your shoulder.

Instead, physicians must be available for consultation on cases and be available to sign off on the care given.

PAs can’t open their own businesses, which can be considered a downside to when comparing PAs to MDs. But, PA education is generalized, so, unlike MDs, PAs have the ability to switch specialties years into their practice if they wish.

The AAPA finds once a PA has chosen to practice in primary care or a non-primary care specialty, 75% will continue their career along that path. When they do change practices, they tend to move within the same general area, sticking with either primary or non-primary care specialties.

Over four decades of data shows 49% of practicing PAs changed their specialty at least once. From a 2015 survey, the AAPA found women were more likely to change specialties, and the most common reasons for any PA to change specialties were because they were ready for a change, to seek a better work-life balance, or to increase their pay.

Physician assistants also enjoy the benefit of working more flexible hours. As medicine moves from a hierarchical model to one more welcoming of collaboration, PAs are in a unique position because they have a foundation of collaboration with healthcare professionals, families, and administrators.

MDs, on the other hand, stick to more of a top-down approach when it comes to patient care.

Collaboration is crucial as the healthcare system moves toward bundling charges and payments based on performance and outcome measures. So regardless of whether you choose a medical profession as an MD or a PA, you must be able to collaborate with specialists when you reach the limit of your personal expertise.

PA vs MD: Financial Compensation and More

It is important to note that while many make this decision based on financial factors, compensation must not be the only factor that goes into deciding between an MD vs a PA career. While a higher salary may be tempting, other factors, such as a long and rigorous program, mountains of debt, and a floundering work-life balance must be considered.

PA Salary and Job Outlook

The Bureau of Labor Statistics reports the average salary for a PA in 2018 was $108,610, with an expected growth rate of 31% from 2018 to 2028. The demand continues to increase with a growing and aging population. In 2018 the Bureau of Labor Statistics estimated there were 118,800 physician assistants employed, and they anticipate that number to rise to 155,700 by 2028.

MD Salary and Job Outlook

The Bureau of Labor Statistics reports the median wage in 2018 was equal to or greater than $208,000 for MDs. They anticipate a 7% growth rate from 2018 to 2028. Although it’s nearly one-third the rate of the estimated growth for PAs, it is still faster than the average for all occupations. This, again, is related to an older population and an increasing rate of chronic illnesses.

MD salary is dependent on subspecialty. According to the BLS, most physicians are family and general doctors, with a 2018 mean annual wage of $211,780, whereas the wage for anesthesiologists was $267,02.

An annual survey of physicians found plastic surgeons have the potential to make over $500,000. This includes bonuses, profit sharing, and deductible expenses for partners.

When comparing PA vs MD job outlook, MD’s slower growth rate may be associated with the adoption of new technologies that reduce the number of doctors needed to complete the same tasks. Whereas with the flexibility of a PA, their versatility will come in handy.

More Than Salary: Other Considerations

While it’s good to know the different salaries that MDs and PAs make, understand that a cursory comparison of annual salaries doesn’t represent a medical professional’s working hours, school debt, or years in school and residency.

The Physician Assistant Life ran an in-depth financial comparison of the actual compensation PAs and MDs earn, taking into consideration a multitude of factors for new graduates, such as:

  • Number of years in school or residency
  • Tuition
  • Debt
  • Annual interest rate on the loans and current tax deductions allowed
  • Potential income during residency
  • Federal income tax rate
  • Number of hours worked a week

The assessment assumed each person lived in California and was married with two children. It also assumed buying power kept up with inflation, and the person’s income kept up with inflation.

The numbers also assumed the number of years worked based on the number of years in school and an average age of retirement. After crunching these numbers, they determined the true hourly wage was:

  • Medical Doctor: $34.46 per hour
  • Physician Assistant: $32.29 per hour

It’s important to note, while this comparison favors the PA profession when compared against an MD in family practice and general/internal medicine, the numbers change if the MD works in one of the higher paying subspecialties, such as dermatology.

Wallet with moneyMaking Work-Life Balance in Medicine

Burnout may result from a lack of work-life balance and is linked to rising healthcare costs, poor patient outcomes, and medical errors. First recognized in the mid-1970s, burnout is generally defined by the experience of emotional exhaustion, a low sense of personal accomplishment, disillusionment, and feeling helpless.

The negative effects of a poor work-life balance often spill over into your home, work, and social life and may trigger changes that make you vulnerable to viral illnesses or chronic disease.

MD Burnout

The statistics for medical doctors and burnout are not positive. In a Medscape survey of over 115,000 physicians in 29 specialties, 42% reported they were burnt out. The top five specialties who reported burnout included urology, neurology, nephrology, endocrinology and family medicine.

This survey also found that burnout affects generations differently, and Generation X reported more burnout than Millennials or Baby Boomers.

When asked to identify what they thought contributed to their experience, 55% said it was bureaucratic tasks and between 24% and 33% reported too many hours, lack of respect, increasing computerization, insufficient compensation, and lack of control/autonomy as reasons for being burned out.

Depending on the generation, from 69% to 77% said burnout had an impact on their relationships. And, despite listing insufficient compensation as one reason for feeling burned out, between 48% and 52% said they would take a pay cut to get a better work-life balance.

Up to 18% reported being depressed, yet only 3% to 6% planned to get help for their burnout or depression, which does not bode well for their patient care.

PA Burnout

PAs are a different story. In a national survey of physician assistants, 92% of the respondents expressed satisfaction with their career choice and current job. Many felt helping others and working in collaboration with a team contributed to these feelings of satisfaction.

A smaller study found PAs were satisfied with their careers and able to balance their work and personal life, reducing their risk of experiencing burnout. And, when studies compared PAs with other medical professionals, PAs generally reported greater feelings of satisfaction with their profession.

PAs also experience burnout. Since a PA’s practice is tied to a physician’s understanding of the capabilities of the role, a lack of leadership and micromanagement may increase the experience of burnout.

PA vs MD: Side-by-Side Comparison

When you make your choice between medical school and a PA program, it’s best to carefully consider the programs and practices of both. Remember that both career paths play different roles on the same team of healthcare providers. There is considerable overlap in a collaborative environment, which ensures the best possible patient care.

It’s also important to note there is no universal right or wrong answer to this question, and only you can answer the question for yourself. Also, remember that healthcare needs both physicians and physician assistants in order to provide the best patient care possible.

Physician Assistant Medical Doctor
Preparation High school and undergraduate degree heavy in sciences – pre-med or pre PA programs High school and undergraduate degree heavy in sciences – pre-med in undergrad
Admission GPA: 3.47 science classes, 3.5 non science classes; 

GRE: 310/ MCAT: optional;

Healthcare experience:2,000 paid, hands-on hours 

GPA: 3.64 science classes, 3.78 non science, 3.70 average;

MCAT: 508;

Healthcare experience: optional

Education 2-3 year program and specialty clinical rotation 4 year medical school, 3-7 year residency, potential fellowship years for subspecialty
School Cost $70,000 – $90,000 $200,000 – $300,000
Flexibility Ability to easily switch specialties;

Can’t open your own business;

Generally no call hours

Works independently;

May own your own business;

Consistent call hours

Compensation $32.29/hour $34.46/hour
Work-Life Balance Burnout: 19.5% experience disengagement – a factor in burnout while up to 92% experience satisfaction with work and feel they balance work and life..

Happy at Work: 80% to 92% report feeling happy at work.

Burnout: Up to 42% report burnout listing bureaucratic tasks, too many hours and lack of respect as some reasons, burnout affected relationships;

Happy at work: 54% to 60% feel happy at work.