Applying to Medical School

PA vs MD: Differences Between Doctors & Physician Assistants

The primary differences between a physician assistant (PA) and a physician (MD or DO) are:

  • Education length and type
  • Clinical rotations
  • Scope of practice
  • Specialties
  • Certifications
  • Salary
  • Work/life balance

Physician Assistants (PAs) and doctors both follow career paths involving hands-on patient care. Both types of healthcare providers have studied hard to have a solid understanding of medical science and clinical experience.

After completing a medical education, both work with their patients to make diagnoses, create treatment plans, and guide people to better health.

Is a PA a doctor? No, a PA is not a doctor. They share many of the same duties and responsibilities of doctors, but they typically work under the supervision of a licensed physician.

What’s the difference between an MD and a DO? Both MDs (medical doctors) and DOs (doctors of osteopathy) are fully-qualified physicians. MDs practice allopathic medicine, primarily focused on the treatment of disease. DOs focus more on the prevention of disease and maintaining the health of the body as a whole.

We break down the differences between physicians and physician assistants to help you make the best choice for your own career.

What is a Physician Assistant?

A physician assistant, or physician associate, is a healthcare professional licensed to practice medicine. PAs are not medical assistants or registered nurses, rather, they are trained to perform many of the same tasks as a medical doctor.

Instead of training at medical school, PAs continue their education through PA programs. Just like physicians, PAs can specialize in specific fields and must go through board-certification exams. Unlike physicians, there is more flexibility in moving between specialties without additional training.

While PAs are involved with providing direct patient care, they are required to work under the supervision of a doctor of medicine.

A quick history lesson to define this profession: Duke University initiated the Physician Assistant (PA) profession in the 1960s as a response to a lack of doctors, drawing from the skills of Navy Hospital Corpsmen. Originally, the program lasted around two years and didn’t include a residency, catering to Corpsmen who already had considerable healthcare expertise.

Fast forward to today, and the profession still values applicants who have substantial clinical experience. Although getting into a PA program without such experience isn’t entirely out of the question, it’s quite challenging, reflecting the profession’s roots in hands-on medical practice.

The differences between the two careers explained in depth.

PA vs. MD/DO: Primary Differences

Physician assistants see patients and are qualified to diagnose and treat most forms of illness and disease. However, they work under a supervising physician. There are also several main differences between a PA’s education, scope of practice, specialty area(s), salary, and work/life balance as compared to a physician’s.

A common misconception about physician assistants is that they have to work with a practicing physician right alongside them. In reality, PAs work independently to provide patient care but must work under a supervising physician who reviews their cases and treatments.

While these healthcare professions are very similar, there are some major differences in becoming a physician assistant vs. physician. We’ve noted where these differences also have variations for allopathic doctors (MDs) versus osteopathic physicians (DOs).

Doctor (MD or DO)Physician Assistant (PA)
Education3-4 years of medical school, followed by 3+ years of residency2-3 year’s in a Master’s physician assistant program
Clinical RotationsIncluded during years 3 and 4 of medical school, usually in internal medicine, general surgery, obstetrics and gynecology, pediatrics, family medicine, and neurology (followed by elective rotations)2,000 hours in addition to a degree program, typically in emergency, family, and internal medicine; general surgery; obstetrics and gynecology; pediatrics; and psychiatry
Practice ScopeCan perform all tasks done by a PA without supervision, prescribe controlled substances in all 50 states plus D.C. and P.R., perform surgery, supervise PAs, and may be needed for complex or rare disease diagnosis and treatmentCan perform physical exams, make diagnoses, determine treatment plans, prescribe drugs (cannot prescribe controlled substances in Kentucky), and order and interpret labs under the supervision of a doctor (MD or DO)
SpecialtiesMust choose a specialty to study during residency (3-4 years or more) and rarely changes during their careerMay alter specialty at any time; most work in primary care medical practice; common specialties include psychiatry, urgent care/emergency medicine, pediatrics, and internal medicine; many PAs work in underserved communities
CertificationsMD: United States Medical Licensing Examination (USMLE)
DO: Comprehensive Osteopathic Medical Licensing Examination (COMLEX)To recertify, doctors must complete a certain number of CME (continuing medical education) hours and renew their state license periodically.
Physician Assistant National Certifying Exam (PANCE)To recertify, PAs must take either the Physician Assistant National Recertifying Exam (PANRE) or complete the PANRE-LA (longitudinal assessment) every 10 years. They must also complete 100 CME hours every 2 years to maintain licensure.
SalaryMD: $200,000* per year
DO: $163,000* per year
*Specialists can earn 2-4 times more, making the pay range much wider.
$125,270 per year
Work/Life BalanceWork over 40 hours per week on average; often work long shifts and are required to be at work or on call nights, weekends, and holidaysWork a standard 40-hour work week; often work only 9-5 shifts

Let’s take a look at a few of these in more detail.


One of the key differences between PAs and MDs is the educational journey. Both PA and MD career paths share the prerequisite of an undergraduate degree, but then the paths split before they begin the full-time healthcare experience.

After getting a Bachelor’s degree, a PA will go to a PA school (physician assistant program or physician associate program) for a Master’s degree for 2-3 years. An aspiring physician must complete 4 years of medical school, followed by 3-4 years or more in a residency program to sharpen the skills necessary for their specialty.

Physician assistants complete a minimum of 2,000 hours of clinical rotations before their certification, and these hours are outside of their Master’s program. The clinical experience for MDs and DOs take place during their third and fourth years of a medical program and during residency.

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Clinical Rotations

Physicians do standard clinical rotations during their third year in medical school, branch out into elective rotations in their fourth year, and work directly with patients in their chosen area of specialty during residency.

The number of hours required for any given doctor to complete in patient care before entering full-time practice differs by program and specialty. During their first two years in clinical rotations, physicians are in school and not paid as practicing healthcare professionals.

Physician assistants are required to complete at least 2,000 hours of clinical rotations during their Master’s education. However, unlike doctors, physician assistants actually complete 2,500 to 4,000 hours of medical experience before being admitted to a PA program.

In most cases, these hours are all required to be from paid positions (volunteer work often doesn’t even count towards admission requirements). This is a non-exhaustive list of some of the jobs many PAs work in patient care before obtaining their Master’s degree:

  • Athletic Trainer
  • Certified Nursing Assistant (CNA)
  • EKG Technician
  • Emergency Medical Technician/Paramedic (EMT)
  • Emergency Room Technician
  • Lab Assistant
  • Medical Assistant
  • Nurse
  • Registered Nurse (RN)
  • Orderly
  • Patient Care Technician
  • Physical Therapy Aide or Technician
  • Phlebotomist
  • Psych Technician
  • Surgical Technician 

Scope of Practice

Under the supervision of a doctor, physician assistants can:

  • Perform physical exams
  • Make diagnoses
  • Determine treatment plans
  • Prescribe drugs (cannot prescribe controlled substances in Kentucky)
  • Order and interpret labs

Doctors may do all of these tasks unsupervised, and may also:

  • Perform surgery
  • Prescribe pharmaceuticals, including controlled substances, in all US states and territories
  • Conduct diagnosis and treatment for more complex or rare conditions not covered by the scope of a PA’s education
  • Supervise physician assistants

The scope of practice for a PA will vary by state law and policies. Most states allow for the scope of practice to be decided by the practice of the PA. 

Some states do not allow PAs to prescribe medications and require the supervising doctor to review and co-sign charts, while other states grant board-certified PAs more autonomy and a broader scope of practice.

As states move to letting practices decide scope, some PAs have to request clinical privileges from institutions, which must then be approved by the medical staff of the facility.


According to the U.S. Bureau of Labor Statistics, the latest median salary for physician assistants was $125,270 per year. The latest median salary for physicians according to the U.S. Bureau of Labor Statistics was greater than $238,700. 

In general, DOs have lower average annual salaries than MDs. The average salary for a specialist physician, such as a plastic surgeon, can be considerably higher.

Read our Medical Speciality Spotlight for more information on physician salaries and specialties.

Benefits of Being a Physician Assistant

  • Being a physician assistant is a more flexible medical profession than the role of a physician. You may change between various medical specialties throughout your career and are more easily able to relocate.
  • Physician assistants have a healthier work-life balance than doctors (in many cases). As a physician assistant, you will work fewer hours than attending physicians. You’re also not required to be on call as often or on irregular days, leaving you to enjoy more holidays and weekends with your loved ones.
  • The education required for a physician assistant is shorter and more affordable than a traditional medical education. You’ll spend less time in school, which equals fewer dollars spent. Also, PAs can get medical experience while actually working in the medical field, meaning they can make money while completing required hours for your licensure.
  • PAs frequently work in primary care, allowing for long-term relationships with patients. While many doctors also work in primary care settings, they spend a little less time with each patient, on average, than the typical PA. If you’re interested in rich, ongoing patient relationships in a primary practice setting, a career as a physician assistant might work great for you!

Drawbacks of Becoming a PA vs. Doctor

  • Physicians enjoy autonomous practice after school. Physicians go through more rigorous schooling and training than PAs, which is a major advantage once the physician begins practicing full-time. Physicians can rise to the head of a healthcare team and have the final say in a patient’s treatment. On the other hand, PAs will always report to a doctor and be slightly limited in their scope of practice.
  • Doctors typically have the most prestige on a healthcare team. An MD is the person who other healthcare members like EMTs, nurse practitioners, and paramedics look to for guidance and answers. 
  • PAs make less money than physicians. A physician assistant typically earns a little over half the annual salary of a doctor, yet performs many of the same daily tasks. There are also fewer high-dollar specialties for a PA to enter, whereas physicians have the option of practicing in specialties where they may make 2-4 times more than the average doctor.

Is it better to be a PA or MD? At the end of the day, your personal preferences will determine if it is better to be a PA or MD. A PA is a highly trained medical professional with flexibility and a great work-life balance, while MDs are specialized with the potential to lead and teach others as they guide people to better health.

How I Chose to Become a Physician Rather Than a PA

As an undergrad, this is a decision I made for myself just a year ago.

Ultimately, choosing between the physician vs. physician assistant route was a decision that required lots of self-reflection. I knew that:

  • Both careers would offer me immense medical knowledge.
  • Going the PA route would mean I’d be working sooner.
  • However, I’d lose the autonomy I’d have if I went the physician route.

My decision ultimately came down to my passion to pursue global health one day, working with various international humanitarian organizations and helping communities in need. The opportunities for me in those arenas are far greater as a physician compared to a physician assistant.

But for many people, there are just as many plusses in the “PA” column. It’s a personal decision that comes down to your own unique situation and preferences.

Choosing a Career as a Medical Professional

If you crave routine, long-term patient relationships, and the ability to improve the health and wellness of your community, a career as a PA might be right for you. Physician assistants more often work in underserved areas, which might be another attractive factor in your decision.

On the other hand, if you thrive on being the leader in your career and are comfortable with the intense responsibilities that come with the career, becoming a doctor might be your best option.

Pre-med students should shadow both physician assistants and physicians and ask questions to fully understand the ins and outs of both professions’ careers. In doing so, you can make an informed decision about which profession to pursue.

Chat with MedSchoolCoach to learn how we can help you succeed on the medical career path you choose.

Yaseen Elhag

My name is Yaseen Elhag. I hold a bachelor's in Health Science and I have aspirations of becoming a physician. I have a deep passion for eliminating healthcare disparities. Some of my hobbies include Mixed Martial Arts, traveling, and playing chess!

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